APPLICATION FORM
Name:__________________________________________________________________
Date of Birth:_____________________________________________________________
Address: ________________________________________________________________
City and Province:_________________________________________________________
Postal Code:_____________________________________________________________
Phone Number:___________________________________________________________
Cell Number:_____________________________________________________________
Email Address:____________________________________________________________
Occupation and Length or Employment:_________________________________________
How Many Days Per Week Do You Work? Hours?_______________________________
Does Your Job Require Extensive Travel?_______________________________________
Who Else Lives in Your House?_______________________________________________
Are the Adults in Your Home Employed?________________________________________
If so, what is their Occupation and How Many Hours/Days Do They Work?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Typically, how many hours a day would the dog spend alone?
_______________________________________________________________________
Who Will Be the Main Caregiver For the Dog?___________________________________
Does anyone in your house hold have allergies to animals? If yes,
describe:________________________________________________________________
_______________________________________________________________________
What dog are you considering adopting?________________________________________
Why are you interested in this dog?____________________________________________
How long have you been considering adopting a dog for?____________________________
What breeds are you considering adopting, and why?_______________________________
_______________________________________________________________________
Why are you interested in this breed?___________________________________________
What type of housing do you live in? (condo, apartment, house)_______________________
How long have you been a resident in your community?_____________________________
How long have you lived at your current address?_________________________________
Do you rent or own?______________________________________________________
If you rent may we contact owner/manager to obtain permission to have
a dog?__________________________________________________________________
Owner/manager's name and telephone number: ___________________________________
If you have a yard, is your completely fenced yard?________________________________
If Yes, what height and type of fencing?_________________________________________
Will this dog be living at the above address? IF not explain:___________________________
_______________________________________________________________________
Where will the dog be kept when you are not home?_______________________________
Where will the dog sleep at night?______________________________________________
Where will the dog stay while you are on vacation?_________________________________
Where will the dog travel in your vehicle?________________________________________
Are you planning on moving in the near future?____________________________________
If you move what will happen to this dog?________________________________________
Is this to be your first pet?___________________________________________________
If not, what kind of pet(s) have you had in the past and how long did
you have these pets for?_____________________________________________________
_______________________________________________________________________
Which of these do you still have? (Include age, gender and breed):_____________________
What happened to the pets you no longer have?___________________________________
Have you ever adopted from a shelter or rescue group before?________________________
Have all your pets been spayed or neutered? If not, why?____________________________
_______________________________________________________________________
Where did you get your previous pets from? _____________________________________
Where did your previous pets stay at night?______________________________________
While you where not at home?________________________________________________
If you currently have pets, will they adjust to a new dog in the
house?_______________________________________________________________________
About how many times do your pets now or any pets visit the
vet per year, and for what reasons?____________________________________________
Which vet(s) have you used in the past? Can we contact them?________________________
If so, name and number_____________________________________________________
What would you do if your dog was diagnosed with a long-term medical
problem?_______________________________________________________________________
How large of a vet bill can you afford at one time?_________________________________
What brand of food would you feed this dog and why?______________________________
Have you ever taken training, private or classes with your previous
dog(s)? If yes, with whom:___________________________________________________
Would you be willing to take training classes with you new dog?_______________________
Have you ever had a dog with behavioural problems? If so, how did
you deal with them?________________________________________________________
How do you praise?________________________________________________________
How do you punish? ______________________________________________________
What are some behaviour traits you do not want in a dog?___________________________
________________________________________________________________________
What issues would you not be willing to work with?________________________________
________________________________________________________________________
If your dog was not house-trained, how would you go about
house-training the dog?_____________________________________________________
If your dog chewed up your shoes what would you do?_____________________________
How much exercise, and what types, can you provide on a daily basis?__________________
What kind of activities do you want to do with this dog?_____________________________
___________________________________________________________________________
Do you feel you can commit to this dog for the next 10 to 15
years?_______________________________________________________________________
Do you understand if you can no longer keep this dog that you are
required to return the dog to Between Fiends Animal Network?_______________________
Have you ever given up one of your animals?_____________________________________
If so why, and to whom?____________________________________________________
Have you ever had an animal euthanized?________________________________________
If Yes, why?_________________ ________________________________________
Are you willing to have a representative of Between Friends Animal Network
do a home visit before you are allowed to adopt a dog?_____________________________
What do you think are some of the possible financial responsibilities
of owning a dog?__________________________________________________________
Do you feel you have sufficient time in your life to comfortably
accommodate a dog?_______ __________________________________________
Briefly describe the expectations you have for this dog:______________________________
Name and phone number of two references, one of which being that of
> your neighbour:__________________________________________________________
_______________________________________________________________________
Any questions or additional comments?_________________________________________
_______________________________________________________________________
_______________________________________________________________________
I certify that the above information is true, correct, and complete.
I verify that I am 19 years of age or older. I also authorize that my
references and my veterinarian can be contacted, and a visit made to my
home before the adoption is complete.
Applicant Signature______________________________Date_____________________