GENERAL INFORMATION How did you hear about AnimalKind? Name * First Name Last Name Age Email * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### ABOUT YOUR ENVIRONMENT Housing Own Rent Landlord's Name Landlord's Phone (###) ### #### Number and ages of children in household Number of adults in household List current pets and breeds Please explain what happened to your past pets Have you owned pets in the past, if so for how long? * Are your pets spayed/neutered? * Are your pets up to date on vaccinations? * If you answered no to the above question please explain why? Have your surrendered a pet to an animal shelter? Yes No If you answered yes to the above question please explain why? Do you have a fenced yard? How big? Where will the dog be when you are not home? Why are you looking for a pet? Will your dog be indoor? Outdoor? Both? Indoor Outdoor Both Are you planning to crate the dog? VETERINARIAN INFORMATION Who is your veterinarian? Address? PLEASE CONTACT YOUR VET ASAP TO PERMIT TALKING TO US. Otherwise your application will be on hold until permission is given. VET TEL: (###) ### #### Are you financially able to provide your pet with annual check ups, vaccinations and vet care as needed? * Yes No What are your plans in the event that you cannot care for your pet any longer? * References PLEASE LIST NON-FAMILY MEMBERS ONLY Reference #1 * First Name Last Name Phone * (###) ### #### Reference #2 * First Name Last Name Phone * (###) ### #### By selecting the box, I am accepting all risks associated with handling animals during the adoption process. I also further attest that the information contained in this document is complete and true. I realize that giving incomplete, misleading or false information will result in being denied the privilege of adoption. I further agree to release all veterinary records pertaining to any animal past/present in my household. * Yes I agree No I don't agree Thank you! Dog Adoption Application