Dog/Puppy Application Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *PhoneAbout YouPlease note that we can only accept applications from the potential owner. We do not accept applications on behalf of other family members.Age of Applicant *You must be 19 years of age or older to adopt from our rescueHome Address *Address Line 1Address Line 2CityState / Province / RegionPostal Code— Select country —AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPlease describe your home *Single FamilyApartmentCondo/ DuplexPublic HousingStudent HousingTrailerOtherDo any children live with you? *YesNoHow many children live with you?– Please select –1234 or morePlease count all occupants or regular visitors under 16 years oldPlease list the ages of the 4 youngest children.Age of child #1Age of child #2Age of child #3Age of child #4Does anyone in your household have a pet allergy? *YesNoNot surePlease provide detailsDo you have a fenced yard? *YesNoAdoption RequestI am interested in adopting *PuppyAdult dogSenior dogAre you interested in a specific dog or puppy?YesNoWhere did you see the dog or puppy?At the adoption centerIn a foster homeFacebookFrom a FriendPlease provide detailsPlease describe your ideal dogPersonality, age, appearance etc.Health and Well BeingHave you owned a pet before? *– Please select –I have owned a pet as an adult and been responsible for its wellbeingMy parents, housemates, or family members owned a petNoHave you owned a dog before?– Please select –I own another dog currentlyI used to own a dog but no longer have oneNoDo you have any other Pets? Please ExplainDo you intend to work with a trainer for your puppy/dog? *– Please select –YesNoNot sureHow many hours each day would your dog be left alone? *None – I am always home1-2 hours2-4 hours4-8 hours8-16 hours16 hours or moreAre you able to take your dog for an annual health check? *YesNoCould you afford to pay for emergency treatment? *YesNoHow much do you expect to spend yearly for your dog (food/vet care/ect)? *Who would take care of your dog if you had to leave town for an emergency? *Are you willing and able to care for your dog for the full duration of its life? *YesNoIf you had to move house and could no longer keep your dog, what would you do? *Confirmation of TermsThe health of a dog is not guaranteed, and the health or personality of a dog can change over time *I agreeIf I am no longer able to care for my adopted dog, I will contact the rescue before rehoming the dog myself *I agreeI will be responsible for all ongoing or one-off costs for medical treatments my dog may need *I agreeSignature Clear Signature Submit