Dog Adoption Form

All fields are required.

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Daytime Phone(Required)

Own or Rent(Required)

Do you own or rent?

Own

Rent

Landlord Info(Required)

If you rent, provide landlord's contact info, including phone number and/or email address.

Other Pets in the Home(Required)

Do you have pets in your home now?

Yes

Other Pets in Household(Required)

Please identify all dogs/cats/other pets currently living in your home.

Veterinary Reference(Required)

If you currently own animals, please list your veterinary reference where vaccination records can be found, veterinary phone number, and whose name they are under. Please contact your veterinarian and give them permission to release your records so that we may finish your pre-adoption form. Then let us know when we can call them.

Adults in Home(Required)

Please list the names of all adults living in the household.

Children in Home(Required)

Are there children in the home? If yes, please indication how many and their ages.

Pet Allergies(Required)

Does anyone in the home have pet allergies?

Yes

Where Will Dog Be Kept?(Required)

Where will you keep this dog?

Inside

Outside

Both

Indoor/Outdoor Explanation(Required)

If you indicated Both, please explain.

How Will You Contain This Dog?(Required)

How will you contain this dog?

How Long Away From Home Each Day?(Required)

How long each day are you away from home?

Animal Ownership Experience(Required)

What is your animal ownership experience?

What Breeds Are You Interested In?(Required)

What breeds are you interested in?

What requirements must this dog have?(Required)

What requirements must this dog have?

How Experienced Do You Feel?(Required)

How experienced do you feel you are as a dog owner?

Additional Comments(Required)

Anything else you would like us to know?

I give the Northwoods Humane Society permission to confirm any information provided in this application that they deem necessary. This information will be held in confidence and used only for the purpose of adoption.

SIGNATURE(Required)

SIGNATURE

Date(Required)

DATE

Challenge(Required)

Please type ADOPTION to prove you are human:

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