All questions must be answered.  If a question does not apply, please enter N/A.  Thank you.

Name(s) of dogs you wish to adopt (include breeds)
Applicant's Name:
Email Address:
If you are 21 or younger, how old are you?
Telephone - work
Telephone - home
Home address
City
County
State
Zip
I understand that if I live outside the application area, All Breed will not process or acknowledge my application. Yes
No
Do you live in a House
Town home
Condo
Apartment
Do you own or rent? Own
Rent
If you do NOT rent your home, are you the owner of the home? Who owns the house?
You must provide the name and phone number of your landlord or condo association within 24 hours or we will move on to the next applicant.
Does anyone in your home have allergies to animals?
Does anyone have asthma?
What size is your yard in square feet?
Is your yard totally fenced in?
Type of fence
Height of fence
Where will the pet be kept during the day? Please provide detail. If in the house, where in the house? If outside, where outside? RESPONSE IS REQUIRED. APPLICATION WILL BE REJECTED IF NOT ANSWERED
Where will the pet be kept during the night? Please provide detail. If in the house, where in the house? If outside, where outside? RESPONSE IS REQUIRED. APPLICATION WILL BE REJECTED IF NOT ANSWERED.
Where will the pet be kept during routine absences such as trips to the grocery store? Please provide detail. If in the house, where in the house? If outside, where outside? RESPONSE IS REQUIRED. APPLICATION WILL BE REJECTED IF NOT ANSWERED.
Do you have a pet door? If so, how is it used, how often is it used, and under what circumstances?
Do you have a kennel run? If so, how is it used, how often is it used, and under what circumstances?
Do you have a dog house? If so, how is it used, how often is it used, and under what circumstances?
Do you have a tie-out stake? If so, how is it used, how often is it used, and under what circumstances?
Do you have a crate? If so, how is it used, how often is it used, and under what circumstances?
How many adults live in your home?
How many children live in your home?
What are the ages of the children?
If you do not have children yourself, are there children who visit your home regularly (defined as once a month)? Describe the situation in as much detail as possible. Are they relatives? Are these children supervised? Please provide details. Failure to respond in detail will delay your application
I understand that All Breed has placed limitations on the types of households in which certain dogs will be placed. For example, some dogs will not be placed in homes with young children. Yes
No
I have read the description of the dog carefully and believe that my household is in compliance with the limitations placed on the dogs placement. (For example, if the description says no cats, the household should not have cats Yes
No
Are you, your spouse or partner, housemate or anyone residing with you currently pregnant? What is her relationship to the applicant and when is the child due? Will the mother and child be living with the applicant following the birth?
Is anyone home during the day? Yes
No
If someone is at home, how long?
Who will be home during the day?
Can they handle the animal you want to adopt? Yes
No
How many hours at one stretch will the pet be without humans each day?
How many hours TOTAL will the pet be without humans each day?
Who will be the primary caregiver?
What is the primary caregiver's relationship to you?
Who will care for the animal while you are on vacation?
What will you do with the animal if you move?
Are you willing and able to provide pet care for the next ten or more years, including vet checks, vaccinations, boarding, medical care, indoor housing, etc.? Yes
No
What do you think pet care costs per year, including animal vaccinations, food, toys, minimal boarding, grooming, etc.?
Are you willing and able to support a pet? Yes
No

Please list all pets you have owned in the past ten years. If none, then include pets owned in childhood. PLEASE LIST ANY ANIMALS RESIDING WITH YOU, EVEN IF YOU DO NOT OWN THEM.

Pet 1 (If none, enter N/A after pet's name)

Pet's name
Breed
Age
Gender
Spayed/neutered
How long owned in years
Is pet alive or deceased? Alive
Deceased
If deceased, how old was the pet when the pet died and explain details of the death.

Pet 2 (If none, enter N/A after pet's name)

Pet's Name
Breed
Age
Gender
Spayed/neutered
How long owned in years?
Is pet alive or deceased? Alive
Deceased
If deceased, how old was the pet when the pet died and explain details of the death.

Pet 3 (If none, enter N/A after pet's name)

Pet's name
Breed
Age
Gender
Spayed/neutered
How long have you owned in years?
Is pet alive or deceased? Alive
Deceased
If deceased, how old was the pet when the pet died and explain details of the death.
Do you have additional pets? Yes
No
If you have additional pets, please list their names, breeds, ages, and genders here. Also specify if spayed/neutered and how long you have owned in years. If deceased, how old was the pet when the pet died and explain details of the death.
If you have ever had a pet lost, disappear, or die at an early age, please provide details (dogs dying before age 10 or cats before age 14).
Have you ever sold, given away, or surrendered a pet?
How do you plan to exercise your dog? (provide details)
Have you ever trained a dog?
Are you willing to give this dog time to adjust to its new environment and family members? Yes
No
How much time are you willing to give the dog to adjust to its new environment and family members?
The animal may not be housebroken. Are you willing to take the time to work with the animal?
Name of past/current vet
Phone number of past/current vet
Name of intended vet
Are there any existing circumstances (e.g., health, family, professional, financial) that could result in your being unable to take care of this dog? What are they?
Why did you choose this dog?
How did you hear about us? Or who referred you?
We require a home visit as part of the application process. Will you comply? Yes
No
We require that all family members, including animals, meet the animal prior to placement. Will you comply? Yes
No
We require a minimum donation of $275 at the time of placement. This money goes to fund medical care, food and shelter for all of our animals, not merely the one you are applying for. Will you comply? Yes
No
Is there anything else we should know that would help us to understand your application?

A rescue representative will conduct a formal interview with you and your family prior to adoption. This interview is to answer any questions about your new pet and to alert you to problems that may arise. The rep will help you plan how to successfully introduce your new pet to your new home and to explain how to help your new pet become part of the family.

Please make sure that you have answered all questions in this application. Failure to provide information necessary to complete this application may cause this application to be voided.

I certify that I have answered all questions honestly and to the best of my ability. I understand that any misrepresentations of fact may result in removal of the adopted pet from my home.

Applicants signature
Date

ADOPTION & FOSTER APPLICATION