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Fluent Forms
ADOPTION APPLICATION
Which dogs are inquiring about?
Name of Applicant
Occupation
Name of Spouse/Significant other
Spouse/Significant Other Occupation
Is he/she aware of and agreeable to this pet adoption?
Yes
No
Home Phone
Cell Phone
Email
Work Phone
Address
City
US States
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST
ARMED FORCES AMERICA (EXCEPT CANADA)
ARMED FORCES PACIFIC
Zip
Names and ages of children (if any)
Have the child(ren) been told of the responsibilities owning a pet entails?
Emergency Contact
Address
City
US States
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST
ARMED FORCES AMERICA (EXCEPT CANADA)
ARMED FORCES PACIFIC
Zip
Phone
Email
Type of Dwelling
House
Appartment
Condo
Do You Have A Fenced Yard?
Yes
No
Do You Own or Rent?
Own
Rent
If Renting, If renting, do you have permission from your landlord to have this pet?
Yes
No
Landlord’s Name
Landlord’s Address
City
US States
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST
ARMED FORCES AMERICA (EXCEPT CANADA)
ARMED FORCES PACIFIC
Zip
Landlord's Phone
Landlord's Email
What are your primary reasons for wanting a dog?
Companion
For your children
Gift
Watchdog
For another pet
Other
If you have children, please describe their previous experience with dogs/cats:
Other pets (name, breed, sex and age of each):
Are Your Pets Spayed and/or Neutered?
Yes
No
Is There Anybody Home During the Day? If Yes, Who?
Will the animal be crated? If “yes”, please explain
How many hours per day will the dog be left alone? Where will it be kept when left alone?
Where will the dog sleep at night? (Kitchen, bedroom, etc)
Do you have a doggie door?
Yes
No
Do you have secure fencing?
Yes
No
How tall is the fence?
Have you recently inspected your fence and is it secure, without holes, gaps, or low points?
Yes
No
Do you have a pool? If yes, is there a secure fence around it?
Who has access to your yard? (gardener, neighbors, housekeeper, etc)
Preferred level of exercise with dog?
Couch potato
Short walks
Vigorous walk
Hike / Jog
How do you normally walk your dog on leash or off leash?
When on leash, I normally use
Collar only
Choke chain
Harness
Gentle leader
Other
When you go on vacation or are gone for an extended period of time, who will care for the pet(s)?
Do you have a regular Vet? If yes, please write vet’s name and phone number
Have you ever given a pet away? If so, please explain
How would you rate your level of dog/cat owning experience?
First time owner
Beginner
Intermediate
Advanced
How will you train this dog/cat?
Obedience class
Hit with newspaper
Firm verbal command
Clicker/hand signals
Other
Are you willing to live with hair on the furniture and your clothes, stains on your rugs, a warm body on your bed, and an animal that might be destructive at times?
Yes
No
Pets are an investment of your time and money. Can you afford to provide the required and proper medical care, grooming, proper diet, shelter and exercise for your new pet? To provide proper medical/veterinary care, including yearly checkups, vaccinations and heart-worm prevention medicine, as well as veterinary care for unusual symptoms such as loss of appetite, coughing, vomiting, diarrhea, blood in urine/stool, allergies, skin conditions, lethargy?
Yes
No
Are you able to make a long-term commitment to care for your pet for its entire life span, which could be as much as 10-20+ years?
Yes
No
Which of the following reasons might prompt you to give up your dog/cat? (check all that might apply)
Excessive barking
Biting
Digging
Moving
Shedding
Divorce
Illness
Allergies
Poor watchdog
Destructive chewing
Excessive vet bills
Financial problems
Accidents indoors
New spouse or partner doesn’t like pet
Aggressive on leash
New family addition
Growling at guests/family members
Other
None of the above
Will you agree to consult and pay for a trainer or behaviorist if problems develop?
Yes
No
Will you agree to register the dog with, and obtain a dog license from the municipality where you live or as required by law?
Yes
No
Will you agree to NOT give or sell the dog to another person, relative, rescue group, humane association, shelter or pound, or any medical or experimental laboratory or similar organization? If you feel the need arises to re-home your pet, you will notify GREENDOG FOUNDATION immediately?
Yes
No
Will you agree to notify GREENDOG FOUNDATION (951) 609-0765 immediately if your pet is lost and to make every reasonable effort to recover the dog/cat?
Yes
No
Please list pets that you have owned since you have been an adult? (Age/Length of Ownership/What Happened)
Why are you interested in adopting from a rescue?
How did you hear about Green Dog Foundation?
Please read and initial each statement below:
I understand that a home visit is required prior to final placement
I understand that a home visit does not guarantee placement
I agree to provide my own collar, leash, choke chain or harness, and personal ID at the time of completing the adoption contract
I can make a donation of at least $425 for an adult dog / $500 for puppies. This is a tax deductible donation and goes to the medical needs of the dog. Anything over that amount will help with medical care, spay and neuter, board and placing other abandoned dogs. (The inability to make a donation does not disqualify an applicant from consideration). I understand that any donation or contribution is a gift freely given, not a purchase price for a dog.
Yes
No
By typing your name and date below, you agree that all of the above is true
Your Full Name
Date
Submit
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