Dog Adoption Application

Welcome to our online secretary....

Dog Adoption
I Would Like to Adopt:
Your Information
First Name:
Last Name:
Address:
Address Cont.:
City:
State:
Zip Code:
Phone Number:
Email Address:
House Information
Live In?:
Rent/Own?:
Renters - Please Fill Out, Otherwise Skip to Next Section
Lease Allow Pets?:
Pet Restriction?:
Landlord/Lease Owner Name:
Landlord/Lease Owner Contact:
Please understand that we will be contacting your Landlord/Lease Owner for confirmation of lease terms.
I Understand:
- Yes
- No
Dog's Area to Roam
Fenced Yard?:
Dog Kennel:
Dog Will Have:
- Run of the House
- Limited to a Portion of the House
- Outside Only
Dog Will Be Walked:
Family Information
How Many Adults?:
How Many Children?:
Any Other Pets?:
- Dog
- Cat
- Bird
- Other
If you have pets, please fill out this section, if not, please skip to the next section.
Are Your Pets Altered?:
If No, Why?:
Up To Date on Shots?:
Vet's Name:
Vet's Number:
Any Comments?
Let Us Know:
Please acknowledge that Lone Pine Shelter does not refund adoption fees if the dog is returned after one week unless other approved before the one week deadline.
I Understand:
- Yes
- No
Please acknowledge that once your application has been approved, you will be required to sign a contract to finalize the adoption of the dog. This application and related fee is not a guarantee of availability of the dog.
I Understand:
- Yes
- No
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