Adoption Application

First Name *

Last Name *

Preferred Phone Number *

Additional Phone Number

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Please note: Submission of an application does not guarantee that the specified dog will be available for adoption upon approval. We often receive multiple applications for the same dog.

Occupation *

Employer Name *

Employer City/State *

What type of home you do you live in? *

Do you have a fenced yard? *

Yes, my yard has a complete and secure above-ground fence.
No, my yard does not have a complete and secure above-ground fence.

Do you rent or own your home? *

Personally own
Live with homeowner
Rent

Personal References. Please provide contact info for three personal references that do not live in the home with you.

First Reference

First Reference Full Name *

First Reference Relationship *

First Reference Email *

First Reference Phone *

Second Reference

Second Reference Full Name *

Second Reference Relationship *

Second Reference Email *

Second Reference Phone *

Third Reference

Third Reference Full Name *

Third Reference Relationship *

Third Reference Email *

Third Reference Phone *

Are there any dogs or cats (indoor or outdoor) currently living at your residence? *

Yes
No

Have you ever given away, sold, abandoned, surrendered or put a pet to sleep? *

Yes
No

Has a pet ever disappeared or been killed, injured, or mistreated while in your care? *

Yes
No

Number of people living in home including yourself? *

Number of people in home under 21 years old? *

Name and Age of each individual under 21? *

List reasons why you want a dog. *

What conditions or circumstances would cause you to give up a pet? *

What size of dog and personality characteristics would best suit your home? *

Please list any size, breed, or qualities.

Which dog(s) are you interested in? (We are only accepting applications for available dogs listed on our website - if you do not list a specific dog, your application may not be processed.) *

What is it about this dog(s) that appeals to you? *

If the dog(s) you are interested in is no longer available, will you consider other dogs? *

Yes
No

Are you aware of the financial obligation of owning a dog? *

Yes
No

Do you agree to provide annual vet care for the dog, including, but not limited to, an exam and vaccinations? *

Yes
No

Do you agree to obtain rabies vaccinations for the dog as required by law? *

Yes
No

If you adopt a dog under six months of age that is not yet spayed/neutered, do you agree to spay/neuter the dog at six months of age? *

Yes
No

What would you do if your new dog chews belongings or shows other destructive behavior, and what action would you take to correct the behavior? *

Where will your new dog be when everyone has left the home? *

Inside
Crate/kennel
Garage
Outside

What is the longest your dog will be left alone in the home with no potty breaks? *

0-4 hours
4-8 hours
8-9 hours
More than 9 hours

Where will your dog sleep? *

Inside
Crate/kennel
Garage

Please provide any additional information on where your dog will be when everyone has left the home, the longest your dog will be left alone and where your dog will sleep.

How will your dog be exercised, and how often? *

When will your dog be allowed Off Leash? *

Dogs often need an adjustment period when transitioning to a new home. They may need time to decompress before meeting new dogs and people, have potty accidents, or appear anxious. Are you willing to work with your dog on any issues that may arise? *

Yes
No

How long do you feel a new pet, and pets already in the home, should be given for an adjustment period? *

Have you adopted a dog from 4 Luv of Dog Rescue before? *

Yes
No

How did you hear about 4 Luv of Dog Rescue? *

Is the information you provided in this application true and correct to the best of your knowledge? (Your application to adopt will be revoked if any information is found to be false or incorrect.) *

Yes

Are you 21 years of age or older?

Thank you for your interest in adopting!

We are sorry, but our policy requires applicants to be 21 years of age or older.

If you are a renter, does your landlord give permission to allow a dog?

Please make sure the owner’s pet policy allows you to have a dog.

We can only allow a rescue dog at your home if the owner gives permission.

Are all pets in your home spayed/neutered and up to date on vaccinations?

All pets must be spayed/neutered and up to date on vaccinations in the applicants' homes.

Thank you for understanding that our goal is to help reduce overpopulation and keep our pets healthy.

Is everyone in the home in favor of adopting a dog?

We require that everyone in the household is in favor of adopting a dog.

Thank you for understanding.

Will your dog sleep inside?

We require that all adopted dogs have a safe and comfortable place to sleep.

Thank you for understanding.

Are you willing to have a 4 Luv of Dog Rescue volunteer visit your home?

We require that a 4 Luv of Dog Rescue volunteer visits your home to continue the adoption application process.

Thank you for understanding.

First Reference

Second Reference

Third Reference

First Veterinarian

Second Veterinarian

Third Veterinarian

Additional Veterinarians

Adoption Application

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