Dog Adoption Application (Page 2 of 3) in pdf

 How many hours a day will the dog be unattended?________________________________

 When no one is home, where will the dog be kept?_________________________________

 Do you plan on chaining the dog? ______________________________________________

 How far from the road/traffic is your home/farm located?__________________________

 Is the volume of traffic? Light____________Heavy____________Moderate____________

 Have you ever had a companion animal (pet) before? ______________________________

 List & describe those pets you own/care for or that are living in your household.

_____________________________________________________________________________

 List & describe those pets you have owned before, but no longer care for.

_____________________________________________________________________________

 Where are the pets you no longer care for now?

_____________________________________________________________________________

 Are your pets current on their vaccinations?_______________________________________

 Are your pets spayed and neutered? _____________________________________________

 Please provide name and phone number of your veterinarian(s).

_____________________________________________________________________________

 Do we have permission to check your veterinary reference? __________________________

Please sign below if you give permission to a Humane Society A.L.L. volunteer to call and obtain information from

your veterinarians(s) regarding the type and quality of pet care that you provide to your past or present pets?

_______________________________________________

____________________________

Signature of Approval to Check Veterinary Reference

Date

Dog Adoption Application Page 2