DOG APPLICATION

If so, list number of pets by type (ex: 2 Chihuahuas, 1 Australian Shepherd)

Are you able to come home during the day from work? *

Yes

No

List the names and phone numbers of 2 references unrelated to you: *

If you currently own pets, list their vet's name, address, and phone number.

Address *

If you rent, please enter your landlord's full name and phone number.

Is noise a concern? *

Yes

No

Phone *

Ages of other members in household *

Occupation *

Rent or Own? *

Rent

Own

Are all members of the home in agreement of adopting a dog? *

Yes

No

Is anyone in your home deployed? *

Yes

No

Why do you wish to adopt a dog? *

Do you have a fenced yard? *

Yes

No

Will you consider obedience training? *

Yes

No

Age *

Name of dog you wish to adopt: *

How did you hear about CAPS? *

How do you plan to meet the toilet and exercise needs of the dog? *

Where will the dog be kept during the day? *

Provide a pet history (up to 10 years) of all of your pets, to include gender, age, where they are now, etc: *

Where will the dog be kept at night? *

Have you owned a pet before? *

Yes

No

Who would be the primary caregiver? *

Is anyone in your home allergic to pets? *

Yes

No

Which pets do you no longer own and why? *

List the most important responsibilities in owning a dog: *

What training methods do you plan on using if you adopt a dog? *

Approximately how many hours a day would the dog be left alone? *

0-4 hours

4-6 hours

6+ hours

Under what circumstances would you give up a dog? *

Are you aware of CAPS's spay / neuter policy? *

Yes

No

Is shedding a concern? *

Yes

No

Name *

Will the dog be tied up? *

Yes

No

Sometimes

Email: *

Gender preference: *

Male

Female

No preference

Have you submitted applications to other rescue organizations? *

Yes

No

Are there any other pets living in the home? *

Yes

No

Have you ever lost or given away a pet? *

Yes

No

Energy Level: *

Low

Medium

High

Who would care for the dog if your family went on vacation? *

If you have other pets, are they spayed and/or neutered? *

Yes

No

Some

I do not have any other pets

Are you willing to sign an adoption contract? *

Yes

No

Have you ever had a pet die at a young age or from an accident? *

Yes

No