Dog Adoption Application | Belly Rub N Grub

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Belly Rub N Grub

DOG/PUPPY ADOPTION APPLICATION

Are you ready to adopt a canine friend? Please complete and submit our online Dog/Puppy Adoption Application form. We will be in touch with you shortly.

Date

Month

Day

Year

Name of dog/puppy*

Why do you want to adopt this dog/puppy?

Please share the reason(s) you wish to adopt this dog/puppy? (250 characters)*

Your required information:

First name*

Last name*

Email*

Cell Phone*

Alternate Phone*

Street Address*

Address Line 2 / Apt. No.*

City*

State*

Zip Code*

Please select from one of the following:

Please tell us about your living situation:*

I am a homeowner

I am a renter

Other

How many people are living in your home?*

I live by myself

I live with an adult and/or child

Other

Your New Pet's Environment

Where will the dog/puppy be kept?*

Indoors

Outdoors (in a safe and secure enclosure)

Both

Who will take care of the dog/puppy when you leave town?*

Pet will be my companion

Family/Friends

Boarding Facility

Pet Sitting Service

How many hours will the dog/puppy be left alone during the day?*

Seldomly - No of _______hours

During the day - No of ______hours

During the night - No of ______hours

Where will the dog/puppy be kept during the day?*

Where will the dog/puppy be kept during the evening?*

Veterinary Information

Name of veterinary clinic*

First Name*

Last Name*

Street Address*

Street Address / Apt. No.*

City*

State*

Zip Code*

Phone*

Email*

Commitment to your pet

Are you willing to give this dog/puppy the time needed to destress and settle into a new environment?*

Yes, as much as it takes.

I will wait to see how it goes.

What dog/puppy behaviors or life changes could make you unable to keep the dog/puppy? (Examples: aggression, housetraining, divorce, job loss, moving, or children.) Maximum 750 characters.*

If behavioral issues arise, are you willing to seek professional guidance and put in the time and training needed to work through them?*

Yes

Signature

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