Name of the dog you want to adopt
Full Name
Age
Occupation
Employer
Home Phone
Cell Phone
Work Phone
Email Address
Best time to contact me
Street Address
City
State
Zip
County
CO-APPLICANT
Please list the Name, Gender, Age and relationship to the applicant.
Is anyone in your home allergic to dogs?
How long have you been looking for a dog to adopt?
What traits are you looking for in a dog?
(To select multiple traits, hold down the CTRL key and click on as many traits as apply)
What attracted you to this dog?
Why do you want to adopt this dog?
Will this be your first dog as an adult?
Which family member/s will be responsible for the dog's daily care (feeding, walking, etc.)
Approximately how many hours per day will your dog be left alone?
Where will the dog be when no one is at home?
Who will take care of your dog when you leave for extended periods of time (vacation, out of town, etc.)?
As your new dog adjusts to its new environment, a few “accidents” may occur. What methods would you use to help your new dog with any “accidents”?
How much time are you prepared to allow for your new dog to adjust to your home?
What traits would you NOT be able to tolerate in a dog?
If your new dog developed any of the traits that you would NOT be able to tolerate, what would you do?
Your PETS
Current Vet's Name
Current Vet's Phone Number
Please list the Name, Breed, Gender and Age of each pet currently living in your home.
When was your current pet's last visit to a veterinarian and why?
Have you ever given an animal away to someone or relinquished an animal to a shelter?
If yes, what were the circumstances?
Your HOME
How long have you lived at your current address?
Describe the neighborhood in which you live.
How would you classify your home?
Do you have a fenced in yard?
If Yes, what type of fence is it?
Will you be leash walking your dog when not in a fenced in area?
Do you own your home?
If you rent your home...
Landlord’s Name
Landlord's Address
Landlord's Phone Number
By submitting this completed application, I hereby certify that the information provided herein is true and correct. I hereby give permission to Cedar Farm to contact any parties to verify the information provided. I agree that Cedar Farm may conduct a home visit.
I understand that there is a standard adoption donation of $300.00 to help offset vetting services and care provided by Cedar Farm.
CHILDREN or other persons living in the home
APPLICANT
