Step 1 of 3 33% ApplicantFirst Name*Last Name*Date of Birth*Primary Phone*Secondary PhoneEmail* Confirm Email Address*Home Address*City, State, Zip Code*Co-ApplicantFirst and Last NameDate of BirthEmail AddressConfirm Email AddressPrimary PhoneSecondary PhoneAdditional informationPlease provide the names & ages of all people living in the home.Please provide occupation of all adults living in the home.* What activity level suits your home best?* Any High Average Calm Is there a specific dog you are interested in?* Yes No Which dog are you interested in?Have you ever had a dog before?*Select OneYesNoPlease list all current pets living in the home. (Name, Age, Breed, Sex, Spayed/Neutered.) Current Veterinarian InformationDo you currently have a veterinarian?*Select OneYesNoNamePhone NumberDo you Give us permission to contact your veterinarian for a reference?*Select OneYesNoIs your yard fenced?*Select OneYesNoWhat type/ height is the fence?We do home visits to help get our dogs settled, when is the best time of day to scheule this?*Please list the name and number of two non-relative personal refrences.Additional notes or comments you wish to share: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 Δ
