Adoption Application

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Name of the dog you are applying for: *

Why do you want to adopt this dog? Why do you think they might be a fit? *

Who are you adopting this dog for? *

Who will be responsible for the care of this dog? *

Are you over the age of 18? *

Yes No

Date of Birth *

Please list all family members or people living in the home with you, including ages for children. *

How often do other children visit your home? (0-17yrs) *

Do you or anyone living in the home suffer from allergies to dogs or have asthma? *

Yes No

If you answered Yes to the above question, how will these allergies be managed with a dog in the home? *

How busy is your family? *

Very busy Moderately Not busy

What type of home do you live in? *

Apartment/ Condo Townhome/ Duplex Singe Family Farm/ Acreage

Do you rent or own your home? *

Own Rent

If you rent, will you be able to provide, in a timely fashion (72 hours, in most cases), written confirmation from the landlord that this dog is allowed to reside in the dwelling? *

Yes No

Have you, or any others that reside in the household, ever been convicted of neglect or cruelty to animals? *

Yes No

Have you ever owned a dog before? *

Yes No

If yes, do you still have that dog? If not, why? *

Have you ever surrendered a pet before? *

Yes No

If Yes, please describe. If No, please type N/A. *

Are there other animals living in the home (include all animals)? Please describe (species, breed, gender, age, name) *

If there are other cats, dogs or rabbits in the home, are they spayed or neutered? If No, please describe why. *

How much do you think it costs (per year) to take care of your dog? *

What are the kind of expenses that a person would have when adopting and caring for a dog? *

How long will the dog be alone on weekdays (on average)? *

How long will the dog be alone on weekends (on average)? *

Do you have a fenced yard? *

Yes No

If your yard is fenced, please describe (height, material, etc.). Do you feel that there is potential for a dog to escape the yard in any way? *

Where could the dog spend its time when you're home? (ie. in the home, fenced yard, crate, garage) *

Where will the dog stay when you're not home? (kennel, garage, small area of house, loose in house, yard?) *

If you are away on vacation, where would the dog stay or how would it be cared for? *

Describe your thoughts on activity for the dog. What kinds of activities or exercise are good for dogs? Are these things that you like/plan to do with your dog? *

How much time can you devote to the exercise of your dog? Describe amount of time, weekdays/weekends, where, how, etc. *

What is the name of the Vet clinic you use? Type N/A if you are not currently using a vet clinic). Please include the phone number and the name of the vet. *

Please tell us about your ideal dog *

What type of breed are you looking for? *

Age *

Size when full grown *

What about their coat? *

Why would you return or surrender your dog? *

Please provide two character references with contact information for both. *

Can we schedule a home visit in your home? *

Yes No

If your answer was No, please describe why this wouldn't be possible. *

Is there anything further that you would like to share with us? Is there something that we haven't covered in the application that you feel is important? *

By providing my full name in the field below, I agree that the information that I have provided to Alberta Homeward Hound Rescue Bureau is correct and true, to the best of my knowledge. I have not falsified my responses and I understand that my application can be denied if it is determined that I have not been truthful in this application or if Rescue volunteers determine that it is not in the best interest of the dog to be adopted by me. *

Today's date *

Submit My Application