Adoption Application Form - 6dogrees Rescue

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Adoption Application Form

Thank You! You have made the noble and wonderful decision to adopt a dog. By choosing to adopt a dog, you allow us to "save-it-forward" to rescue another dog, and you provide a life to a dog that they never would have had without you!

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Name *

First

Last

Email *

Primary Phone Number *

Other Phone Number

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Age *

Occupation *

Is there a particular dog you're interested in adopting? *

Are other adults living at home? Who? *

Do all the adults in the home know you're hoping to adopt a dog? *

Yes
No

Who will primarily be responsible for the dog's care? *

Any children in the home? What ages? *

What is the child(ren)'s experience with dogs? *

Are there kids that visit your home? (grandkids, neighbors, etc) *

Does anyone in the house have allergies to dogs? *

What are your reasons for wanting to adopt a dog? *

What are the qualities you're looking for in a dog? *

What concerns do you have about adopting? *

Do you own your home or rent *

Own
Rent

What is your landlord's name? *

First

Last

What is your landlord's phone number *

What type of dwelling? *

House
Apartment
Condo
Other

Are pets allowed? *

Yes
No
Small Ones Only
I'm not sure

Are you willing to let us do a home-check? *

Yes
No

Do you have a fenced yard? *

Yes
No

What kind of fence do you have? *

Will you tie up your dog outside? *

How many hours a day will the dog be alone? *

When the dog is alone, will it be inside or outside? *

When the dog is alone, will a care-taker visit for potty breaks? *

How often do you travel? *

What will you do with your dog when you're away? *

How many / what kind of pets do you currently have? *

If you have any other dogs, have they been spayed/neutered? *

Additionally, are they up to date with their vaccines? *

What other pets have you had within the last 10 years? *

Who is your current or most recent veterinarian? *

Please know, even dogs that are housebroken will go through an adjustment period. We save last-hour shelter dogs who have been eating, sleeping and pooping on concrete. Are you willing to train the dog and seek professional training assistance if needed? *

Under what conditions would you not keep your new pet?

Are you open to fostering a dog? *

Yes
No

How did you hear about this adoption resource? *

Anything else you want us to know? Additional comments or questions? *

I certify that all the information here is true, to the best of my knowledge. *

Driver's License Number

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