Step 1 of 7 14% ApplicantFirst Name*Last Name*Primary Phone*Secondary PhoneEmail* Confirm Email Address*Home Address*City*State*Zip Code*Driver's License #*Driver's License State*Date of Birth*Co-ApplicantFirst and Last NameEmail AddressConfirm Email AddressDate of BirthPrimary PhoneSecondary PhoneDriver's License #Driver's License State Age DesiredSex*Select OneFemaleMaleEitherActivity Level*Select OneHighAverageCalmAnyIs there a specific dog you are interested in?* Yes No Which dog are you interested in?Why are you interested in this particular dog?How did you find out about Adore?* Please provide the names & ages of all people living in the home.Do they share your interest in adoption?*Select OneYesNoN/AIf no children, are you planning on children?*Select OneYesNoMaybeHave you ever had a dog before?*Select OneYesNo Please list all current pets living in the home.Name, Species, Sex, Spayed/Neutered, Age, TempermentPlease list your most recent pets that no longer live in the home.Name, Species, Sex, Spayed/Neutered, Age, TempermentCurrent Veterinarian InformationDo you currently have a veterinarian?*Select OneYesNoNamePhone NumberAddressCityStateZip CodeWhere do you plan to purchase your heart worm preventative?*Which brand do you use?*Where do you plan to purchase your flea/tick preventative?*Which brand do you use?* How long have you lived at your current address?Do you rent or own?*Select OneRentOwnPlease provide landlord name and phone number.*Does your landlord allow dogs?*Select OneYesNoUp to what size?*How long will the dog be left alone daily (without humans)?*Will the dog be allowed in the house?*Select OneYesNoWhere will the dog stay when you are away from the house?*Are you familiar with the use of dog crate training?*Select OneYesNoIs your yard fenced?*Select OneYesNoWhat kind of fence?* Will your dog receive formal obedience training?*Select OneYesNoAre you aware that routine costs average $500/dog/year?*Select OneYesNoHave you ever sold, given away, or surrendered a pet to a shelter?*Select OneYesNoPlease explain the circumstances.*Please tell us why you want a dog.*Please tell us a little about your lifestyle, your family and activities.*Do you have any special requirements or requests?*Select OneYesNoPlease list and/or explain requirements or requests.Please let us know who will care for your dog when you are on vacation.* Please list one professional reference (non-relative).Name*Company Name*Phone Number*Email Address*Street Address*City*State*Zip Code*We do home visits prior to placement. When is the best time of day?*Do you give us permission to contact your veterinarian for a reference?*Select OneYesNoPlease list the name and number of two non-relative personal references.*I/we attest that the information provided on this application is true and accurate to the best of my/our knowledge.* Agree I/we understand that completion and submission of this application does not guarantee adoption of a dog.* Agree This iframe contains the logic required to handle Ajax powered Gravity Forms.