Dog Adoption Application

Please indicate which dog(s) you're interested in:

Full Name

Email Address

Address 1

Address 2

City

State

Zipcode

Home Phone

Work Phone

Mobile Phone

May We Text You? May We Text You? Yes No

I live in: I live in:HouseApartmentTownhouse / CondoMobile Home

Do you: Do you:Own ResidenceRent ResidenceLive with relatives

Name and contact number of your landlord or management company:

Are you currently employed? Are you currently employed? Yes No

How long have you lived at your current address?

Please list the names and ages of all people who live in the home full or part time, including yourself

Is this pet a gift or surprise for someone? If so, who?

Who will be the primary caregiver for the dog(s)?

Does anyone in the household smoke cigarettes?

Why do you want to adopt a dog?

Have you adopted from us before, and if so, which pet and when?

How many hours a day will the dog be unattended?

Where will the dog be kept while you are not home?

How will you housetrain your new pet?

Please list name, age, size and breed of all pets you currently own

Are they all spayed or neutered? Are they all spayed or neutered? Yes No

Why are some of your pets not spayed or neutered?

How many pets have you owned in the past 10 years?

Where are they now?

Where do your current pets live?

Where will your new dog live?

Where will your new dog sleep?

How will your new dog be exercised?

Is there a yard available? Is there a yard available? Yes No

Is it fenced? Is it fenced? Yes No Partially

How tall is the fence and what type?

Are your current pets up to date on shots? Are your current pets up to date on shots? Yes No

Please provide the name and phone number of your current veterinarian. NOTE: Your application cannot be completed without contact information for the veterinarian who has your current pets' most up to date vaccination records.

What type of dog food do you feed or plan on feeding your dog?

What do you plan to do with your dog when you go on vacation?

Are you aware of heartworm cause and prevention? Are you aware of heartworm cause and prevention? Yes No

Have you ever taken a dog to a shelter? Have you ever taken a dog to a shelter? Yes No

Why did you take your dog to a shelter?

If approved, when do you plan to bring your new pet home? If approved, when do you plan to bring your new pet home? Within the next 48 hours Within the next week Within the next month

If you are outside the metro Atlanta area, are you willing and able to personally travel to meet and adopt this pet within the very near future? Please note: we have placed animals all over the country, but we do not ship or transport animals under any circumstances - you MUST travel to us to adopt from us. If you are outside the metro Atlanta area, are you willing and able to personally travel to meet and adopt this pet within the very near future? Please note: we have placed animals all over the country, but we do not ship or transport animals under any circumstances - you MUST travel to us to adopt from us. Yes No

Would you object to an authorized Society of Humane Friends representative inspecting the premises where the animal will be kept both before and after adoption? Would you object to an authorized Society of Humane Friends representative inspecting the premises where the animal will be kept both before and after adoption? Yes No

Please provide the name and phone number of a personal reference:

Comments

I attest that the above information is accurate. I am also relieving the Society of Humane Friends of any and all liability during the viewing and adoption process. I attest that the above information is accurate. I am also relieving the Society of Humane Friends of any and all liability during the viewing and adoption process. I agree