Canine Adoption Form Thank you for considering adopting from

 Canine Adoption Form Thank you for considering adopting from Barlee’s Angels! How did you hear about us? Applicant Name: Is the applicant over 21 years of age? yes
Name of primary caregiver: How many people live in the home: • adults over 21? • persons ages 16 through 21? • persons ages 10-­‐15? • persons ages 4-­‐9? • persons under age 4? Home Address: How long have you lived at this address? Phone Number(s) where we can reach you: • daytime • evening How early and how late in the day can you take phone calls? Email address (one you check frequently): What is the relationship of the adults in the home to the primary caregiver? Is anyone in the home unsure about getting a dog? If so, why? Dwelling Type: Do you own your rent
House
house or rent? Do you plan on moving in the next 12 months? yes
If so, what will you do with your pet? Do you have a fenced yard? yes
• What type of fencing? • Height of fence? • Is the yard completely enclosed? yes
other
What is your purpose for a getting a dog? Where would your dog spend its time during the day? crated in house
Where would your dog spend its time during the night? crated in house
How many hours will your dog be left alone on work days? What are your plans for your dog when you go on vacation? Size of dog preference? no preference Age preference? no preference
Gender preference? no preference
Coat type? no preference
Desired activity level? no preference
Other desired attributes: good with dogs
Are you interested in specific breeds? Only those breeds? What are your plans for exercising your dog? Your dog may not be house-­‐trained. How do you plan to house train your dog? What are your plans for basic obedience training for your dog? What dog training approaches do you feel are most successful? Please provide contact information for 2 personal references and indicate their relationship to you. Please provide contact information for the veterinarian who cares for your pets (past and present pets). Please contact your veterinarian’s office and give consent for a Barlee’s Angels volunteer to call for a reference for you. Are you agreeable to paying an adoption yes
fee for a rescued animal and to signing an adoption agreement? Please list all of the pets you have owned for the past 10 years (past and current pets). Please include temporary pets. In the comments, note cause of death for deceased pets. Had
Spayed
Comments about pet
Pet Name
Kind
Location
Neutered? Age babies
?
dog
lives with me
dog
lives with me
dog
lives with me
dog
lives with me
dog
lives with me
dog
lives with me
dog
lives with me
dog
lives with me
dog
lives with me
lives with me
dog
lives with me
dog
dog
lives with me
lives with me
dog
Please add any additional information that you feel we might need to process your application.