Pets Alive Animal Sanctuary

Dog Adoption Application

Contact Info

First Name: *

Last Name: *

Email: *

Street Address:

City:

State/Province Select:

Select state/province from list

Postal Code:

Phone Number:

Phone Type:

Alternate Phone:

Phone Type2:

Home

Mobile

Work

Household Info

Are you over 18?

Yes

Do you own or rent your home?

Own

Rent

If you rent, please tell us your landlord’s name and phone number::

How many children live in the home, and what are their ages?

How many hours each day will the adopted animal be without human companionship?

Previous Pet Info

What animals do you CURRENTLY have? Include age, sex, breed and species.

What happened to the pets you no longer have?

Are all your current pets spayed or neutered?

Yes

Don't Know

Have you ever had a pet euthanized?

Yes

If yes, please explain further:

Have you ever turned in a pet to a shelter?

Yes

If yes, please explain the circumstances:

Have you ever applied to Pets Alive before to adopt an animal?

Yes

If yes, when?

Please check this box if you are filling this application out AT Pets Alive (as a walk-in), this will help us process your application most efficiently.