First Name (required)
Last Name (required)
Your Email (required)
Date of Birth (YYYY-MM-DD) (required)
Primary Phone Number (required)
Other Phone Number
Address 1 (required)
Address 2
City (required)
State (required) ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Zip/Postal Code (required)
Country
Number of years you have lived at this address: (required)
Type of Residence (required) ---HouseDuplexApartmentCondoMobile Home
Do you rent? (required) YesNo
If yes, name of Landlord
Landlord Phone Number
List all people, including yourself, in your home- along with the ages of everyone:
What are your plans for this dog if you move?
Does everyone in your household know your plans to adopt a dog? (required) YesNo
Is anyone in your household allergic to dogs? (required) YesNo
If yes, what are your plans to control these allergies?
Please rate your household activity level (required) 1 - Low Key2345 - Moderate678910 - Highly Active
Primary Employer
Number of years you've worked there
Full or Part Time? Full TimePart Time
Address of Employer
City of Employer
State/Province of Employer State (required) ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Zip/Postal Code
Do you have other household income? YesNo
Other Employer Name
What dog of ours are you interested in? (required)
Why? (required)
What is your dog ownership experience? (required) ---I am a first-time dog ownerI have had one or two in my lifeVery knowledgeable/experienced
Who will be primarily responsible for the dog? (required)
Where will the dog be kept? (required, check all that apply) In the house (free roam)In the basementIn a crate insideIn a closed-off room insideIn the garageTied up outsideOutside in a kennelOther
On average how many hours per day will the dog be left alone? (required)
How would you resolve behavior problems such as chewing, barking, digging, fence jumping, etc.? (required)
Are there any behaviors that you would be unable to live with/tolerate?
Have you ever adopted from this shelter? (required) YesNo
If Yes, when?
Have you not been chosen or declined? (required) YesNo
If Yes, please explain
Have you adopted from another shelter? (required) YesNo
Have you ever surrendered a pet to a shelter? (required) YesNo
If Yes, what shelter and when?
How many pets live in your home now? (required)
PET #1
Name of Pet #1
Breed of Pet #1
Age of Pet #1
Pet #1 is: MaleFemale
Pet #1 is Spayed or Neutered YesNo
Do you still own Pet #1? YesNo
Are all vaccinations current for Pet #1? YesNo
PET #2
Name of Pet #2
Breed of Pet #2
Age of Pet #2
Pet #2 is: MaleFemale
Pet #2 is Spayed or Neutered YesNo
Do you still own Pet #2? YesNo
Are all vaccinations current for Pet #2? YesNo
PET #3
Name of Pet #3
Breed of Pet #3
Age of Pet #3
Pet #3 is: MaleFemale
Pet #3 is Spayed or Neutered YesNo
Do you still own Pet #3? YesNo
Are all vaccinations current for Pet #3? YesNo
Please list the same information above for any additional pets you may have in your home at this time
List all of the veterinary facilities you have used for each pet:
What personality characteristics do you seek in a new pet and what activities do you hope to do together? (required)
Signature
I UNDERSTAND THAT COMPLETING AN APPLICATION FOR ANY LISTED ANIMAL DOES NOT GUARANTEE THE ACCEPTANCE AND FINALIZATION OF THE ADOPTION FOR SAID ANIMAL. IN UNDERSTAND THAT IF MY APPLICATION IS NOT CHOSEN FOR SAID ANIMAL, I MAY STILL BE ELIGIBLE TO ADOPT ANOTHER ANIMAL AT ANOTHER TIME FROM BOB'S HOUSE FOR DOGS AND THAT MY APPLICATION WILL BE KEPT ON FILE AT BOB'S HOUSE FOR DOGS
I AUTHORIZE INVESTIGATION OF ALL STATEMENTS IN THIS APPLICATION AND UNDERSTAND THAT VETERINARIANS, OTHER ANIMAL SHELTERS, LANDLORDS, ETC. MAY BE CONTACTED.
I CERTIFY THAT I AM AT LEAST 18 YEARS OF AGE. I UNDERSTAND THAT THIS APPLICATION IS NOT AN ADOPTION CONTRACT, AND THAT THE ADOPTION WILL BE DELAYED UNTIL MY APPLICATIONS (AND OTHER APPLICATIONS THAT MAY BE RECEIVED FOR THE SAME ANIMAL) HAVE BEEN FULLY PROCESSED.
I agree to the terms stated above YesNo
Name: (required)
Date (YYYY-MM-DD) (required)
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Email Address (required)
Subject
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