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Dog Adoption Application

1Applicant

2Family

3Home

4Care

5Preferences

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Default: Adopter Status
First Name*
Last Name*
Age Range*
eMail Address*
Street Address*
Suite | Apt or Unit Number
City*
State/Province*
ZIP*
This field is hidden when viewing the form
Country
Home Phone Number
Work Phone Number
Cell Phone Number*
- Preferred Method of Contact*
Employment & Schooling
- Are You Employed?*
  - Yes
  - No
  - Retired
- Name of Employer
- How Did You Hear About Us?*
- What Is Your Friend's Name?
- Please Describe
- Have you adopted a rescue dog before?*
  - Yes
  - No
- From What Organization?*

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
Is There Another Adult Applicant In The Home? (i.e. Spouse, Partner, etc.) If married, your Spouse/Partner MUST be listed as the Co-Applicant.
- Yes
- No
How Many?*
Adult 1
First Name*
Last Name*
Age Range*
Relationship To Applicant*
Please Describe*
Phone Number*
Work Phone Number*
eMail Address*
Are They Employed?*
- Yes
- No
- Retired
Name of Employer*
Adult 2
First Name*
Last Name*
Age Range*
Relationship To Applicant*
Please Describe*
Phone Number*
Work Phone Number*
eMail Address*
Are They Employed?*
- Yes
- No
- Retired
Name of Employer*
Adult 3
First Name*
Last Name*
Age Range*
Relationship To Applicant*
Please Describe*
Phone Number*
Work Phone Number*
eMail Address*
Are They Employed?*
- Yes
- No
- Retired
Name of Employer*
Adult 4
First Name*
Last Name*
Age Range*
Relationship To Applicant*
Please Describe*
Phone Number*
Work Phone Number*
eMail Address*
Are They Employed?*
- Yes
- No
- Retired
Name of Employer*
Children
Are There Children In The Home?*
- Yes
- No
How Many?*
Child 1
Age*
Previous Experience with Dogs:*
Does the child live with you full time?*
- Yes
- No
Child 2
Age*
Previous Experience with Dogs:*
Does the child live with you full time?*
- Yes
- No
Child 3
Age*
Previous Experience with Dogs:*
Does the child live with you full time?*
- Yes
- No
Child 4
Age*
Previous Experience with Dogs:*
Does the child live with you full time?*
- Yes
- No
Dogs
Do You Have Any Dogs Currently Living In Your Home?*
- Yes
- No
How Many?*
Have You Owned Any Dogs Within The Past 10 Years Who No Longer Live In Your Home?*
- Yes
- No
Dog's Name*
Breed*
Length of Ownership*
How Did Ownership End?*
Dog 1
Dog's Name*
Breed*
Age Range*
Gender*
Is The Dog Altered? (Spayed or Neutered)*
- Yes
- No
Is The Dog An Inside or Outside Dog?*
- Inside
- Outside
Sociability*
Sleeping Quarters*
Is The Dog Updated On Their Vaccines?*
- Yes
- No
Date of Last Vaccines?*
How Many Years Have You Owned This Dog?*
What Brand of Heartworm Prevention Do You Currently Use?*
What Brand of Flea and Tick Prevention Do You Currently Use?*
Dog 2
Dog's Name*
Breed*
Age Range*
Gender*
Is The Dog Altered (Spayed or Neutered)*
- Yes
- No
Is The Dog An Inside Or Outside Dog?*
- Inside
- Outside
Sociability*
Sleeping Quarters*
Is The Dog Updated On Their Vaccines?*
- Yes
- No
Date of Last Vaccines?*
How Many Years Have You Owned This Dog?*
What Brand of Heartworm Prevention Do You Currently Use?*
What Brand of Flea and Tick Prevention Do You Currently Use?*
Dog 3
Dog's Name*
Breed*
Age Range*
Gender*
Is The Dog Altered (Spayed or Neutered)*
- Yes
- No
Is The Dog An Inside or Outside Dog?*
- Inside
- Outside
Sociability*
Sleeping Quarters*
Is The Dog Updated on Their Vaccines?*
- Yes
- No
Date Of Last Vaccines?*
How Many Years Have You Owned This Dog?*
What Brand of Heartworm Prevention Do You Currently Use?*
What Brand of Flea and Tick Prevention Do You Currently Use?*
Dog 4
Dog's Name*
Breed*
Age Range*
Gender*
Is The Dog Altered (Spayed or Neutered)*
- Yes
- No
Is The Dog An Inside or Outside Dog?*
- Inside
- Outside
Sociability*
Sleeping Quarters*
Is The Dog Updated on All Vaccines?*
- Yes
- No
Date of Last Vaccines?*
How Many Years Have You Owned This Dog?*
What Brand of Heartworm Prevention Do You Currently Use?*
What Brand of Flea and Tick Prevention Do You Currently Use?*
Veterinarian Information
Have You Used a Veterinarian Before?*
- Yes
- No
Please Provide Veterinarian's Full Name (First and Last Names)*
Please Provide Veterinarian's Clinic Name*
Please Provide Veterinarian's Phone Number*
In The past 10 Years, Have You Used Another Veterinarian?*
- Yes
- No
Please Provide Veterinarian's Full Name (First and Last Names)*
Please Provide Veterinarian's Clinic Name*
Please Provide Veterinarian's Phone Number*
Other Pets
Are There Other Pets Currently Living In The Home?*
- Yes
- No
How Many?*
Other Pet 1
Animal Type*
Pet's Name*
Is There Any Additional Information You Would Like to Add?
Other Pet 2
Animal Type*
Pet's Name*
Is There Any Additional Information You Would Like to Add?
Other Pet 3
Animal Type*
Pet's Name*
Is There Any Additional Information You Would Like to Add?
Other Pet 4
Animal Type*
Pet's Name*
Is There Any Additional Information You Would Like to Add?

Residence
- Type of Residence*
- Please Describe Type of Residence
- Do You Own or Rent?*
- Does Landlord Allow Dogs?*
  - Yes
  - No
- Are There Any Breed Or Size Restrictions?*
- Please Provide Landlord's Name*
- Please Provide Landlord's Phone Number*
- How long have you lived at this address?*
Yard Information
Tails of Hope Dog Rescue has a total restraint policy. If you are in a home with a yard, it must have a secure fully attached fence to the home, such as wood or chain link. You must have a door from the home that has direct access to your securely fenced yard. If you have a yard and it does not have a securely attached fence the application will NOT be approved. WE DO NOT ACCEPT INVISIBLE FENCES.
- Do You Have A Yard?*
  - Yes
  - No
- Is The Yard Fenced?*
  - Yes
  - No
- How High Is The Fence?*
- What Is The Lowest Point of The Fence?*
- What Material Is The Fence Made From?*
- Please Describe Fence Material*
- How Many Doors Lead Directly From Inside the Home Into Your Fully and Securely Fenced Yard?*
- How Many Gates Does the Fence Have?*
- Are the Gates Locked?*
- What Type of Locking System Do the Gates Have?*
- Do You Have A Pool?*
  - Yes
  - No
- Is The Pool Completely Fenced?*
  - Yes
  - No

Family & History
- What Type Of Household Do You Have?*
- Please Describe*
- This field is hidden when viewing the form
  Is Everyone in the Residence and Family Agreeable to Adopting?*
  - Yes
  - No
- This field is hidden when viewing the form
  Do All Family Members Want A Dog?*
  - Yes
  - No
- Is Any Member Of Your Household Allergic To Dogs?*
  - Yes
  - No
- Does Any Member Of Your Household Smoke?*
  - Yes
  - No
Are You WIlling To Take Responsibility For This Dog For The Next 10-15 Years?*
- Yes
- No
What Provisions Will You Make For The Dog Should You Become Unable To Care For Him/Her?*
- Are You Capable of Providing Timely Healthcare?*
  - Yes
  - No
- What Are You Willing/Able To Spend On Annual Vet Care?*
- Please Explain Your Circumstances*
Sleep & Alone Time
- Where Will The Dog Sleep?*
- Where Will The Dog Be When Alone?*
- Please Describe Where The Dog Will Be*
- Do You Have A Doggie Door?*
  - Yes
  - No
- Is It Locked When You Are Away From Home?*
  - Yes
  - No
- If You Are Gone From Home During The Day, Does Someone Let Your Dogs Out?*
  - Yes
  - No
- What Is The Longest Time The Dog Will Be Alone (without humans)?*
- Who Will Care For The Dog While You Are On Vacation?*
- Please Explain Who Will Care For The Dog*
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)?
Needs Social Skills*
Accidents In The House*
Inappropriate Chewing*
Excessive Barking*
Digging*
Separation Anxiety*
- Other
  - Yes
  - No
- Please Explain Other Behaviors You Cannot Tolerate*
- What Are Your Plans For Training Your New Dog?*
- Please Describe Your Training Plans*
First Personal Reference
Please Note: References Cannot Be Related to You or Currently Living With You
Please Provide First Reference's First Name*
Please Provide First Reference's Last Name*
Please Provide First Reference's Phone Number*
Relationship to Applicant*
Second Personal Reference
Please Note: References Cannot Be Related to You or Currently Living With You
Please Provide Second Reference's Second Name*
Please Provide Second Reference's Last Name*
Please Provide Second Reference's Phone Number*
Relationship to Applicant*
Third Personal Reference
Please Note: References Cannot Be Related to You or Currently Living With You
Please Provide Third Reference's First Name*
Please Provide Third Reference's Last Name*
Please Provide Third Reference's Phone Number*
Relationship to Applicant*
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Veterinarian Information
This field is hidden when viewing the form
Have You Used A Veterinarian Before?*
- Yes
- No
This field is hidden when viewing the form
Please Provide Veterinarian's Name*
This field is hidden when viewing the form
Please Provide the Veterinarian's Clinic Name
This field is hidden when viewing the form
Please Provide Veterinarian's Phone Number*

Reason For Adoption
Select all that apply.
Please Check the Characteristics for Which You Have a Strong Preference.*
Describe the Personality, Temperament, and Special Characteristics You Are Looking for in a Dog.*
Would You Consider:
Fostering While Waiting For The Perfect Dog?*
Two Dogs?*
A Dog That Can Be An Only Pet?*
A Dog That Is Afraid Of Small Children?*
A Dog That Needs Medications?*
- A Dog that Has Special Needs?*
- Please Select All Special Needs(s) You Would Accept*
  Select All That Apply:
- A Dog That is Not Completely Housebroken?*
Do You Have A Preferred Dog?*
Note: This does not guarantee this dog will be placed with you
Please Describe Your Reasons for Wanting This Particular Dog.*
List Other Dogs You Are Interested In
When Will You Be Ready To Adopt?*
Under what possible circumstances would you return the pet?*
Is There Anything Else You Would Like to Let Us Know?
I am interested in receiving pet related services and products*
- Yes
- No
Authorization
If You Adopt this Dog, Will You Consent to Occasional Contact to Ensure the Dog is Doing Well in Your Home?*
- Yes
- No
What is the Best Time to Call You at Home to Check on How the Adopted Animal is Adjusting?*
Are you aware that a set non-refundable donation is collected for all adoptions to help defer costs for the care and medical treatment of adoptable dogs? Payment must be made by cash or online payment apps currently accepted by the rescue (i.e., Venmo, PayPal.) Personal checks are not accepted.*
- Yes, I/We Are Aware That There Is A Set Adoption Fee.
- No, I/We Are Not Aware That There Is A Set Adoption Fee.
Authorization:*
By signing to the right, I acknowledge that I have read this questionnaire completely, comprehend it fully, know that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application or the adoption contract can result in the forfeiture of an animal adopted by me. I give permission for Tails of Hope Dog Rescue to use all information I have provided in consideration for approval of adoption. I give permission to have the information checked, shared, am at least 25 years of age (unless waived) and agree that submission of this form will constitute a legal document once signed. I acknowledge and agree to a home visit for my application for adoption be approved.*
- I agree
Phone
This field is for validation purposes and should be left unchanged.

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