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Your Family |
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| Name of other responsible adult (ORA) who will also care for this pet, if there is one |
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| ORA's Occupation |
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| ORAr's Place of Employment |
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| How many adults in your household? (*) |
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| How many children? (*) |
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| Children(s) age(s) |
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| Tell us about other children, adults, pets that may spend a lot of time visiting your house. |
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| Are all members of the household willing to be responsible for a new pet? (*) |
*required |
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| Would you say your level of physical activity as a family is: (*) |
*required |
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| Does anyone in your house have allergies to any animal? (*) |
*required |
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| You live in: (*) |
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| Is there a fenced yard? (*) |
*required |
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| What type of fencing? |
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| How high is the fence? |
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| If you rent, please supply us with your landlord's contact name and phone number. |
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| If you rent, do you have to pay a pet deposit? |
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| If you have a pet deposit, how much is it? |
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Your Pets |
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| Pet 1 Type |
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| Pet 1 Age |
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| Pet 1 Sex |
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| Spayed/Neutered? |
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| Pet 1 current on (select all that apply) |
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| What happend to the pet if no longer with you? |
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| Pet 2 Type |
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| Pet 2 Age |
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| Pet 2 Sex |
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| Spayed/Neutered? |
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| Pet 2 current on (select all that apply) |
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| What happend to the pet if no longer with you? |
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| Pet 3 Type |
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| Pet 3 Age |
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| Pet 3 Sex |
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| Spayed/Neutered? |
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| Pet 3 current on (select all that apply) |
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| What happend to the pet if no longer with you? |
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| What other pets do you have? |
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| Who in your house is primarily responsible for caring for the pets? |
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| Current/most recent veterinarian/clinic |
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| Current/most recent veterinarian/clinic phone |
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| Have you ever had to give up a pet? (*) |
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| If yes, please tell us what happened. |
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Care and Training |
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| Is this your first experience with a dog? (*) |
*required |
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| What are the main reason you want to adopt a new dog? (*) |
*required |
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| Who will be the main caretaker for this dog? (*) |
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| How long will the dog be left alone at a time? Include your commute time. |
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| Have you used a crate before? |
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| Where/how will the dog be confined on your property during the day: (*) |
*required |
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| Where/how will the dog be confined on your property during the night: (*) |
*required |
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| Other information that may be relevant with regards to confinement of the dog (dog walker, doggy day care, etc.): |
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| Have you ever been to a dog park? |
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| What arrangements will you make for your pet when you travel or are on vacation? (*) |
*required |
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| What will you do if the dog develops behavior problems after adoption? (*) |
*required |
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| Have you ever used a professional trainer before? (*) |
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| Will you use a trainer or attend classes to help this dog polish basic obedience skills? |
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| Do you plan on working with this dog to pursue agility, K9 Good Citizen Certification, certification as a therapy dog? (*) |
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| How did you hear about us? (This will help our marketing so please answer.) |
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| If you had a referral from a friend or a group, please let us know who it was: |
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I understand that misrepresentation or omission of facts on this application is cause for denial of adoption. I authorize investigation of all statements contained in this application. I understand the Urban Pet Project has the right to deny any application. I understand that shelter animals have unknown medical backgrounds and the Urban Pet Project cannot guarantee the health and behavior characteristics of adopted animals. |
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| Type your initials in the box to confirm your understanding. (*) |
*required |
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| Type in the text you see here: |
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Adoption 
