L.I.F.E. Animal Rescue Dog Aplication for puppy

PLEASE READ FIRST! : We try very hard to match the right dog into the right family so that everyone is happy. Due to the large number of applications received, you will only be called if this dog will be the right match for you. Thank you so much for your time and interest!

Name (* require ) First Last
Address (* )
Street Address

Address Line 2(Apt, unit number, etc.)
City State Zip Code
Phone 1 (* ) ### - ### - #### Contact Phone 1 (* ) Daytime Evening
Phone 2 ### - ### - #### Contact Phone 2 Daytime Evening
Email (* )
I would like to adopt (* ) :
Have you ever adopted from us before? (* )

Please select one
Have you ever filled out one of our applications before? (* )

Please select one

-- Please answer all questions below. --

1. Who shares your household? Spouse Parent Significant Other Roommate Children Live Alone
Please check the box(es)
2. What are the ages of your children, if any?

If you have no children, please leave as blank.
- Is this the child’s first pet?
Please select one, if you have children.
3. Do you live in a:
Please select one
4. Do you own or rent?
Please select one

- If you rent, do you have landlord permission for a dog?
Please select one, if you are renting
5. Is anyone in your household allergic to dogs?
Please select one
6. What type of dog are you looking for?
Please select one
7. Do you have a doggy door?
Please select one

- If no, would you consider putting a doggy door in?
Please select one, if you DON'T HAVE a doggy door

- If yes, does your doggy door have access from:
Please select one, if you HAVE a doggy door
8. Is the dog allowed on the furniture?
Please select one
9. Where would the dog sleep at night as a Puppy?
Please check box(es)
Patio Doghouse Dog Run Kitchen Crate Laundry Room Garage Bedroom Anywhere in the House Anywhere Outside
10. Where would the dog sleep at night as an Adult?
Please check box(es)
Patio Doghouse Dog Run Kitchen Crate Laundry Room Garage Bedroom Anywhere in the House Anywhere Outside
11. If you have a dog now or had a dog previously, where do they or did they sleep at night? Please note the specific room or area in or out of the house:
Please type
12. Do you plan on using crate training at any time?
Please select one

- If so, when?
Please type, if you select "Yes"
13. Is anyone home during the weekday?
Please select one
14. Who is home?
Please type name

- How many hours is nobody home on a normal weekday?
Please type name and hours
15. When you are home, will the dog have:
Please select one
16. When you are not home, will the dog be put :
Please select one
Outside only Crate Part of the house with outside access Full run of house with outside access Inside with full run of House Inside with partial run of House
17. Is your yard securely fenced?
Please select one

- Height of fence?
Please type the hight, if you have a fence

- Type of Fencing?
Please type the hight, if you have a fence
18. Do you have a pool?
Please select one

- Is it fenced off?
Please select one, if you have a pool
19. Do you have grass in your yard?
Please select one
20. What type of exercise do you plan on doing with your dog and how often?
Please type
21. Do you have a dog run area on the side of your house?
Please select one

- If yes, is your dog:
Please select one, if you have a dog run
22. Have you ever had a dog before?
Please select one

-If yes, what happened to your dog(s)?
Please type, if you had any
23. Do you have any other dogs now?
Please select one

- If yes, how many and what type?
Please type, if you have any
24. Do you have any other type of animals?
Please select one

- What Kind?
Please type, if you have any
25. Are all of your animals spayed/neutered?
Please select one

- If no, why not?
Please type, if No
26. What type of dog food do you feed or have fed in the past?
Please type
27. Where will your pet stay when you go on vacation?
Please type
28. Under what circumstances would you give up your dog?
Please check box(es)
Moving New Baby Divorce Barks too much Digs Housetraining Problems Nips/Bites Large Vet Bills Untrainable/Out of control I would never give up my dog