NORTHWEST HILLS K9 RESCUE, INC.



ADOPTION APPLICATIONThe dog I / we are interested in is: __________________________Personal InformationName:Address:City: State:Zip:Cell phone:Home Phone:Work phone:Email:Occupation: Age: 21-30 ___ 31-40 ___ 41-50 ___ 51-64 ___ over 64 ____Ages of Children living at home:Number of Pets, age, Sex and Breeds of dogs living in home:HOUSINGWhere do you live? Please highlight all that apply Single Family Home Condo Apartment Mobile HomeIf renting, do you have the landlord’s permission to have a dog? Yes NoIf renting, name and address and phone # of landlordHow long have you lived at this address?Where will your dog be kept? Highlight all that apply HouseKennel with doghouseyard with doghouseOther (please explain) Is anyone home during the day to feed, exercise and let out the puppy during the day?? Yes NoIs the yard fenced in? yes NoIf adopting a puppy 6 months or youngerOn average how many hours will your puppy be left alone?How many hours a day would the puppy be kept outside alone?Have you ever owned a dog before? Yes No If yes, how many and what breeds How long did your pet live? What were the circumstances of the dog’s death?Have you ever returned a pet to the breeder? Yes No If yes, what were the circumstances?Have you ever given a pet away? Yes No If yes, what were the circumstances?Have you ever taken a pet to a pound or a shelter? Yes No If yes, what were the circumstances?Have you ever had a dog euthanized? Yes No If yes, why?What do you expect your dog’s activity level to be? Please highlight Very High High moderate below averageTRAININGHave you ever house trained a dog before? Yes NoWill you agree to enroll you puppy into 6 weeks of puppy kindergarten training beginning no later than 12-14 weeks old? Yes NoWill you be attending other training classes? Yes No What type of temperament are you looking for in your dog/puppy?Do you own livestock? Yes No Numbers and type.Where did you hear about Northwest Hills K-9 Rescue? VETERINARINAN INFORMATION Name of current veterinary clinic: Phone of current veterinarian:NOTE: Standard medical care costs from $200-$500 per year. Emergency care can cost hundreds to thousands of dollars. Are you willing to provide standard and emergency care for this pet? REFERENCESPlease no relatives, only friends, neighbors, co-workers, etc.Please list 3 references name, email and Cell phone, relationship to you and years known.Name: Cell Phone:Email:Name: Cell Phone:Email:Name: Cell Phone:Email:Please Feel Free to add any other information that will assist me in making the correct match not only for the dog but for your family as well. Not every dog is right for every family; we work hard to make the match work for everyone. We want you to feel you have the best dog in the world!_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ................
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