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Dog Adoption Application

1Applicant

2Family

3Home

4Care

5Preferences

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Default: Adopter Status
First Name*
Middle Name*
Last Name*
Age Range*
eMail Address*
Street Address*
Suite | Apt or Unit Number
City*
State/Province*
ZIP*
County*
This field is hidden when viewing the form
Country
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Home Phone Number
This field is hidden when viewing the form
Work Phone Number
Cell Phone Number*
Preferred Method of Contact*
- Email
- Text
- Phone Call
What is Your Occupation?*

Below are three areas for information on other members of your family. Please include all other adults, children and pets living in your home by clicking on the designated button.
Adults
Are There Other Adults In The Home?
- Yes
- No
How Many?*
Adult 1
First Name*
Middle Name*
Last Name*
Age Range*
Relationship To Applicant*
Please Describe*
What is their Occupation?*
Do all of the adults in the home know of your intention to adopt a new dog?*
- Yes
- No
Adult 2
First Name*
Middle Name*
Last Name*
Age Range*
Relationship To Applicant*
Please Describe*
What is their Occupation?*
Do all of the adults in the home know of your intention to adopt a new dog?*
- Yes
- No
Adult 3
First Name*
Middle Name*
Last Name*
Age Range*
Relationship To Applicant*
Please Describe*
What is their Occupation?*
Do all of the adults in the home know of your intention to adopt a new dog?*
- Yes
- No
Adult 4
First Name*
Middle Name*
Last Name*
Age Range*
Relationship To Applicant*
Please Describe*
What is their Occupation?*
Do all of the adults in the home know of your intention to adopt a new dog?*
- Yes
- No
Children
Are There Children In The Home?*
- Yes
- No
How Many?*
Child 1
Ages of children in the home:*
Child 2
Ages of children in the home:*
Child 3
Ages of children in the home:*
Child 4
Ages of children in the home:*
Pets
Do you currently have any pets?*
- Yes
- No
This field is hidden when viewing the form
How Many?*
Please provide the type, name, age, and sex of each current pet:*
How many dogs or cats have you owned in the last five years?*
Please list name, species, breed, age, if they are indoor/outdoor, etc of EACH current pet. If a pet is no longer living, please explain what happened to those pets.*
Are all of your pets spayed/neutered AND up to date on core vaccines (rabies and distemper)?*
- Yes
- No
please explain why your pet is NOT altered or up to date on core vaccines*
Have you adopted from ARPO in the past?*
- Yes
- No
what was the pets name?*
Please list the veterinarian or vet clinic name and phone number who is/was treating your pets for wellness/routine care and vaccines:*
May we contact your vet for a reference?*
- Yes
- No
Have you ever given up a pet?*
- Yes
- No
why and what did you do with the pet (e.g. surrendered it to a shelter or rescue, gave to someone)?*
Describe any experience you have with pet training or obedience:*
What would be unacceptable pet behavior that might cause you to give up a pet?*
Does anyone in your household have allergies to dogs or has anyone had them in the past?*

Residence
- Type of Residence*
- Please Describe Type of Residence
- Do You Own or Rent?*
- Are there any restrictions (such as weight, breed, number of pets, cats must be declawed, etc)? Your landlord will be contacted for details.*
- Please Provide Landlord's Name*
- Please Provide Landlord's Phone Number*
- Have You Moved Within The Last Year*
  - Yes
  - No
- Please provide your previous address*
Yard Information
Do You Have A Yard?*
- Yes
- No
Is The Yard Fenced?*
- Yes
- No
How High Is The Fence?*
What Material Is The Fence Made From?*
Please Describe Fence Material*

Family & History
- What Type Of Household Do You Have?*
- Please Describe*
- Do All Family Members Want A Dog?*
  - Yes
  - No
- Please Explain Who Doesn't and Why They Don't*
- Does Any Member Of Your Household Smoke?*
  - Yes
  - No
Are you prepared to make a long-term (10-15 years) commitment to care for this dog? (This may include birth of children, moving, death in the family, divorce, etc.)*
- Yes
- No
What will you do with the dog if you move?*
What provisions will you make for the dog should you be unable to continue to care for it?*
- Are you prepared financially to deal with the cost of both routine (vaccinations, annual exams, dental cleanings, flea/tick/heartworm prevention, parasite control, etc.) and emergency vet care of a new pet?*
  - Yes
  - No
- What do you plan to budget for annual vet care (routine & emergency) for this dog?*
General Care
- Who will have the primary responsibility of caring for the dog?*
- Describe how you intend to provide exercise for your new dog:*
Sleep & Alone Time
- Where do you intend to keep your new dog the majority of the time?*
- Where Will The Dog Sleep?*
- Approximately how many hours in an average day will the dog be alone?*
- Where will the dog spend the day when you are home?*
- Where will the dog spend the day when you are away (at work, running errands)?*
- Where will the dog sleep?*
Behavior & Training
Dogs Can Take A Month Or Longer To Adjust To A New Home, Particularly If Other Pets Are Involved. Are You WIlling To Devote This Much Time To Make The Dog Comfortable In Your Home?*
- Yes
- No
What Behaviors Can You Tolerate (and work on)?
Are you prepared for the damage that a dog/puppy can do (e.g. soiling indoors, nipping, scratching, digging, chewing, shedding, etc.)?*
- Yes
- No
How will you handle typical behaviors such as soiling indoors, chewing, crying, nipping, digging, scratching, etc.?*

Reason For Adoption
Select all that apply.
Why are you looking to adopt a dog now?*
Will this dog be for yourself or a gift?*
- Myself
- Gift
Would You Consider:
Describe in detail the type of dog you are looking for:*
Do You Have A Preferred Dog?*
Note: This does not guarantee this dog will be placed with you
List Other Dogs You Are Interested In
When will you be ready to bring a new dog home?*
Would you consider another dog if the one you're applying for is no longer available?*
Is There Anything Else You Would Like to Let Us Know?
How Did You Hear About ARPO?*
I am interested in receiving pet related services and products*
- Yes
- No
Authorization
Authorization:*
All of the information in this application is true. I understand that this is a preliminary application and does not guarantee adoption.*
- I agree
Name
This field is for validation purposes and should be left unchanged.

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