Application for Adoption

We are so happy to hear that you and interested in adoption from DOWN DOG RESCUE! Please copy and paste application into an email and send to


Dog Adoption Application Form

Contact Information

Full name:



How long at this address:

Daytime Phone:

Evening Phone:

Best time to call:

Email address:

Family & Housing

How many adults are there in your family (their relationship to you)?

How many children (ages)?

What type of home do you live in single family, town home, apartment, farm, etc.?

Please describe your household: __ Active __ Noisy __ Quiet __ Average

If you rent, please give the rules governing pets and the landlord’s name and number:

(by providing this information you are allowing DDR to contact your landlord please inform them of this

call so they will speak with us)

Does anyone in the family have a known allergy to dogs?

Is everyone in agreement with the decision to adopt a dog?

Do you have time to provide adequate love and attention?

Other Pets

What other pets do you have (specify type and number)?

Are these pets up to date on vaccines?

Are these pets spayed/neutered? If not – why?

Have you every surrendered a pet? If so – why?

Have you ever had a pet euthanized? If so – why?

Have you ever lost a pet to an accident?

How do you discipline (plan to discipline) your pets?


Do you have a regular veterinarian? __ Yes __ No

Veterinarian’s name:

Clinic Name:

Clinic Address:

Clinic Phone:

(Providing DDR with this information you are allowing DDR to call your vet. Please call your vet and ask

them to authorize the release of information to DDR.)

About the Dog You Wish to Adopt

What is your idea of an ideal dog?

Desired age: Desired Size:

Desired breed:

Breed you would not adopt:

Desired sex:

Spayed Female?

Neutered Male?

No preference?

Willing to adopt:

Outgoing dog?

Hyper dog?

Dog that needs medication?

Special needs dog?

Dog that needs regular grooming?

Shy dog?

Where will the dog spend the day? (describe)

Where will the dog spend the night? (describe)

Number of hours (average) dog will spend alone?

Who will have primary responsibility for this dog’s daily care?

Who will have financial responsibility for this dog?

Do you agree to provide regular health care by a Licensed Veterinarian? Yes No

Do you agree to keep the dog as an indoor dog? Yes No

When the dog goes out, how do you plan to supervise it? Fenced yard?

Do you agree to contact DDR if you can no longer keep this dog? Yes No

Are you be willing to let a representative of DDR visit your home by appointment? Yes No

How did you hear about DDR? _____________________________________________________

Would you be interested in fostering? Yes No Would like to know more

Personal References

Please list someone who is familiar with both you and your pets.




Relationship (relative, neighbor, friend, etc.):




Relationship (relative, neighbor, friend, etc.):

All of the information I have given is true and complete. This dog will reside in my home as a pet. I

will provide it with quality dog food, plenty of fresh water, indoor shelter, affection, annual physical

examination and vaccinations under the supervision of a licensed Veterinarian.

___________________________ _________

(Signature) (Date)

One thought on “Application for Adoption

  1. I would like to send you my application prior to the Pet fair this weekend. However, I found two different e-mails for you and neither seemed to work. Please contact me and I will be happy to forward it to you.

    Best – Carin

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