About the Applicant (Must be 18 years of age or older):
Applicant's name:
E-mail address: (Please note that we primarily communicate by e-mail)
Home Phone Number (include area code):
Work Phone Number (include area code):
Cell Phone Number (include area code):
Address:
City:
State:
Washington
Oregon
Zip Code:
Personal Information:
Why do you want a dog?
If there are children in the home, what are their ages?
What has your experience with pets been like in the past? Describe In Detail:
Is anyone in the house allergic to animals?
Does your entire household agree to this adoption?
What You're Looking For:
Breed Wanted:
Age Desired (check all that apply):
Approximate Size (check all that apply):
Sex
Special Requests: (training, color, etc)
If dog is not altered, will it be done within 10 working days?
How long are you willing to give your new dog to adjust to it's new home?
Have you ever attended Obedience Classes?
Are you willing to give a home to an elderly dog, one with medical issues, or one that needs immediate training/obedience classes? Please be specific, because we have some wonderful pets needing new homes due to these very issues.
A dog with medical issues?
An older dog?
A dog with training issues?
Current Living Situation:
Dog to live:
Describe outdoor shelter for dog:
Where will dog sleep (Be specific)?
How many hours will the dog be home alone during the day, on average?
Do you own other pets?
Number of cats or dogs:
Cats:
Are all dogs/cats altered?
If you have an unaltered pet, give your reason for doing so:
Are current pets up to date on vaccinations?
Do all current pets in your home have identification (microchipped, licensed, tags) in case they are lost?
Describe any other pets and livestock:
Current Vet:
Name and Phone Number:
If no current vet, who you plan to use for your new pet?
Name and Phone Number:
How long have you owned your current pets?
What has happened to pets owned in the past? (Be specific)
Do you rent or own?
Landlord's name and phone number, if applicable:
How long do you plan to live here?
Is your home located on:
Traffic on your street is:
Is your yard fully fenced?
If not, how will dog be confined while outside?
Will your dog get daily walks if not in a fenced yard?
Please provide information for three references (other than your vet or landlord) who know you as a pet owner or can vouch for your overall responsibility:
Reference #1
Name
Reference #2
Name
Reference #3
Name
Have you spoken to an SCC adoption counselor already? If so, please list their name:
Please list which dog(s) you are interested in and why they interest you:
