Dog Adoption Application Please DO NOT complete this form until instructed to do so. Dog Adoption Application Adoption Policies To be considered as an adopter you must: Be at least 18 years of age with a legal ID showing your current address. If you rent, be able to verify that you can have a pet where you live. Pet ownership is a major responsibility. In SBACCʼs ongoing effort to find the best possible homes for its animals, we ask that you take the time to fill out this questionnaire and expect to spend some time discussing it with one of our adoption representatives before the adoption is completed. We also ask you to take time to ask one of our volunteers to help you spend time handling the animal you are interested in adopting before you request adoption. The adoption process includes a review of all your answers to the questions below. Please agree to the following by checking each box.Consent 18 Years Old* I am at least 18 years old*Regardless of any verbal approval by a SBACC representative:Consent No Guarantee* I understand that this is only an application and does NOT guarantee that I will be approved*Consent Right to Refuse* I understand that the SBACC has the right to refuse an applicant for ANY reason.*General Information1. Date*Today’s date. MM slash DD slash YYYY 2. Name of Dog*3. Breed / Description*4. Name of Adopter*This is the name of the primary adopter First Last 5. Co-AdopterThis is the name of the co-adopter First Last 6. How did you hear about our shelter?*Please indicate how you heard about our shelter Facebook Instagram Search Engine Pinterest Print Advertisement Pet Finder From a Friend Contact Information7. Address*Specify your address information Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code 8. Phone Primary*Enter your primary phone number9. Phone SecondaryEnter your secondary phone number10. Email* Enter Email Address Please re-enter your Email Address Previous and Existing Pets11. List any pets you currently have in your homeClick the + or – icons to add or remove entries.Breed / TypeAgeSpayed / Neutered?Vaccines Current? 12. List any other pets you have had in the past (as an adult)Click the + or – icons to add or remove entries.Breed / TypeAgeSpayed / Neutered?What happened to this pet? (died?, gave away to other home or shelter?) 13. Have you ever given away a pet?* No Yes If "yes", please explain why?*Residence14. How long have you been at your residence?*Please provide the number of years / months.15. Residence Type* House Apartment Condo / co-op Townhome Manufactured Home RV / Camper / Trailer Boat Other If "other", please describe:*16. Residence property rights* Own with no HOA Own with HOA restrictions Rent / Lease Military Stay with family / friend / partner, etc. Other If "other": please describe:*Please enter your Landlord / Apt Manager's contact information:*NamePhone17. Does your residence have any pet restrictions? No Yes Do not know If "yes", please describe:*18. Yard and residence features*Check all that apply Select All Yard Patio Balcony Stairs Pool / Spa Pet Door Outdoor Kennel Outdoor Dog House 19. About how big is your yard?*Enter the dimensions for the yard. (for example 20 ft x 30 ft)20. Is the Pool/Spa separately fenced?* No Yes 21. What type of fencing is around any outdoor areas the dog will use?* No Fence Block / Brick Wall Wood Vinyl Chain Link 22. What height of fencing is around any outdoor areas the dog will use (feet)?*23. Are there coyotes or other wildlife in your city or town?* Yes No If "yes", please describe:*24. What would happen to your pet if you moved (Please describe)?*Members of Household25. Name of all persons living in your household and their relationship to you:*Click the + or – icons to add or remove entries.NameAge (If under 18)Relationship 26. Who will provide for this dog in the event that you become ill or unable to care for him/ her ?*27. Does anyone in your home have pet allergies?* No Yes Please select the type of allergies*Check all that apply Cats Dogs Other 28. If you have children, do they have experience with dogs?* No Yes There are no children in the home Please describe (type / size / energy of dogs, child's responsibilities, etc)*29. How will they be supervised with a new dog?*About the Prospective Dog30. How do you plan on exercising this dog and how often?*31. How many hours per day would the dog be exercised?*32. Based on your family schedule in a normal week, what is the maximum hours your dog will be left alone?*33. Where will the dog be when you are home?*34. Where will the dog be when you are not home?*35. Is there any time the dog will be confined outdoors without access to the home?* Yes No If "yes", please explain why:*36. Is there any time that the dog will be restricted to a limited area indoors?* Yes No If "yes", please explain why:*37. Where will the dog sleep?*38. Will the dog spend any time in garage?* No Yes 39. Have you been informed of any behavioral problems of the dog you want to adopt?* No Yes What behavioral problems were discussed?*40. If this dog has or develops behavioral problems, what would you do?*41. Are you willing to housebreak, leash train, and behavior train this dog?* No Yes What have you done in the past to train a dog?*42. Which of the following may be reasons for giving up your new dog?*Check all that apply. Excessive barking Digging Biting Destructive chewing Urinary / fecal accidents indoors Food aggression Aggressive on leash/ at dog park Aggressive to other pets in home Excessive vet bills / care Divorce Household member doesn’t like Allergies New baby Other None of above If "other", please explain:*43. Will this dog wear a collar and ID tag?* No Yes 44. Additional Comments or Explanation, If Any:CAPTCHA
