Dogadoptionapplication


	Please copy this application and paste it into an e-mail, or a program like Word and attach it to an e-mail. Westside Strays Dog Adoption Application Name_____________________________________ Spouse/Partner's Name_____________________________ Address_____________________________________________________________________________________ City__________________________________ State________________________ ZIP_____________________ Home Phone___________________________________Work/Cell Phone________________________________ Place of Employment_____________________________________________ E-mail Address_______________________________________________________________________________ Number of Adults in Home______________ Number of Children in Home and Ages_______________________ Name of Dog You Would Like to Adopt___________________________________________________________ Breed or Mix_____________________________________ Color______________________________________ Does everyone in the household agree to the adoption of this dog? _____________________________________ Is anyone in the household allergic to dogs? _______________________________________________________ Which best describes your residence: house, apartment, duplex, condo, mobile home, or other?______________ Do you own or rent your home? _________________ If you rent, please provide the name and phone number of your landlord or leasing company, or a copy of your lease indicating that dogs of this breed and size are permitted on the premises.______________________________________________________________________ What do you plan to do with this dog if you move? _________________________________________________ Do you have a fenced yard? _____________ If so, please indicate the type /height of the fence. _____________ Do you have other pets? _____________ If so, please list types, ages, and whether they are spayed or neutered. ___________________________________________________________________________________________ Please list the name and phone number of your primary veterinarian, and/or the veterinarian who provided your pets' last vaccinations. ________________________________________________________________________ Please list pets you have had in the past, and why you no longer have them.______________________________ Why do you want to add a dog to your family? _____________________________________________________ Why did you choose this breed or mix, and what experience do you have with it?_________________________ ___________________________________________________________________________________________ Why did you choose this particular dog? __________________________________________________________ Approximately how many hours per day will this dog be home alone? ___________________________________ Where will this dog stay when you are not home (crate, free run inside home, outside, etc?)_________________ Where will this dog stay when you are home? ____________________At night?__________________________ Where will this dog stay when you are out of town? ________________________________________________ How much and what type of exercise will this dog receive on a daily basis (ex. two leashed walks per day, game of fetch in the yard, etc.)? _____________________________________________________________________ How much do you expect to spend on this dog the first year, taking into account routine veterinary care, emergency care, training, food, and other supplies such as toys, a crate, bedding, etc.? (Please give a specific dollar amount.) _____________________ How much are you willing to spend on this dog the first year, taking into account routine veterinary care, emergency care, training, food, and other supplies such as toys, a crate, bedding, etc.? (Please give a specific dollar amount.) _____________________ Please read the following statement and sign your name below. I have answered the above questions truthfully and to the best of my knowledge. If I am approved for an adoption by a Westside Strays representative, and, at any time, I am found to have falsified any of the information above, I agree that I will surrender my adopted pet to a representative of Westside Strays immediately. I am aware that my adoption fee will not be refunded, nor will I be reimbursed for any expenses I may have accrued in caring for this animal. I am aware that I will not be given a replacement animal, nor will I be permitted to apply to adopt another animal in the future. ____________________________________________________________________________________________ Signature Printed Name Date