DOG ADOPTION APPLICATION

For the

Pet(s) Named:

Further Identifying Features:

(Breed/Color/Sex):

Where was pet seen?

(eg. Pet store name and location, Petfinder.com, other)

Name of AVA member you were dealing with (if known):

Name of Applicant:

Address:

Phone:Res:

Bus:

Cell:

Email:

Do you live in a: please choose house townhouse apartment condo trailer other

How long have you lived in your current dwelling?

Do you own or rent? please choose rent own still live with parents

If renting, are pets allowed? please choose yes no Is there a weight limit? please choose yes no Limit

Landlord's name

Landlord's phone number

Do you have a please choose fenced yard kennel other

If it is a fenced yard:

Fence type

Fence height

What size is the yard?

If it is a separate kennel run:

Kennel run size:

Do you have a doggie door please choose yes no

If you replied that you do not have either a fenced in yard or kennel how do you propose to maintain housetraining habits and exercise of the dog?

Where will the dog be allowed to sleep?

Are you over the age of 21? please choose yes no

Why do you want a dog?

Describe the personality traits you are looking for in this dog?

What previous experience have you had as a dog owner?

If you have had a pet before:

What type of pet(s) was it?

How long did you have the pet(s)?

What happened to the pet?

If your pet died what was the cause of death?

How long has it been since you have owned a pet?

Have you and your pets ever taken part in pet training classes? please choose yes no

Do you or your roommate(s) currently have a pet? please choose yes no

If yes, please describe the type and personality of the pet(s).

How many adults are in the home and what relationships are they to you?

If you have children, please answer the following questions:

a) How many children live in your home?

b) What are the ages of your children?

c) Do your children’s friends that commonly visit have pets? please choose yes no

or allergies? please choose yes no

If children other than your own visit regularly, give their numbers and ages:

Do all the adults currently living in your home agree with the adoption of this pet: please choose yes no

Is an adult home during the day? please choose yes no

Do cleaning personnel or childcare workers visit regularly? please choose yes no

If you have or had a dog, what is/was the brand name of the pet food used.

For what time period during the day would your dog be left alone and for what reason?

Do you have a friend or relative who would look after your pet/pets when you have to be away from home? please choose yes no

At what age would you spay or neuter your dog?

If anyone in your house suffers from allergies, answer the following questions:

How are you going to live with a dog?

What if the allergies get worse?

What would happen if anyone in your household were to develop an allergy?

For what reasons would you relinquish a dog? please choose fleas getting married or divorced allergies chews or destroys objects too expensive children no longer care for it having a baby moving where no pets are allowed other

Would you return the dog to the party that adopted it out to you? please choose yes no

Do you think you will have sufficient income to meet the occasional extraordinary costs of caring for your pet? please choose yes no

What do you consider reasonable veterinarian care to consist of?

What is your estimate of how much it would cost to feed the dog per month?

What is your estimate of veterinarian costs per year?

If your dog required surgery and it would cost $1000, what would you do?

Is there anything else you would like AVA to know about your home before we consider your application?

Can an AVA representative visit your home? please choose yes no

Please provide the following information regarding your veterinarian:

Name:

Address:

Tel. No.:

Name of pet that visited above vet

Do you give AVA permission to contact this veterinarian? please choose yes no

If you currently do not have a vet please provide personal references (preferably people who know of your capabilities with animals).

Please ensure that you have included your email address and/or your telephone number.

Thank you for filling in this form. Someone should be reviewing it within 24 hours.