Home
Contact Us
Adoptable Dogs
Foster
Foster Process
Foster FAQ’S
Foster Application
Adoption
Adoption Process
Adoption Application
Donate
Partners
Adoption Application
Home
/
Adoption Process
/
Adoption Application
Date(mm/dd/yy):
*
Name of applicant:
*
First
Last
Date of Birth:
*
Name of co-applicant:
*
Date of Birth of Co Applicant
*
Address:
*
Street Address
City
State / Province / Region
Postal / Zip Code
Home Phone:
*
Area Code
-
Phone Number
Cell Phone:
*
Area Code
-
Phone Number
E-mail:
*
Employer
*
Years employed:
Do you own or rent:
*
Own
Rent
Home type:
*
House
Apartment
Condo/Townhome
Trailer
Other
If you rent please provide landlords name:
If you rent please provide landlords phone number:
Are there breed restrictions where you live:
*
Yes
No
Is there a particular dog you are interested in adopting:
*
Yes
No
If yes, name of dog:
Do you have a fenced yard:
*
Yes
No
If yes, please describe the type of fence and height:
Where will the dog be kept during the day:
*
Where will the dog be kept at night:
*
How many hours a day will the dog be alone
*
How do you plan to exercise your dog?
*
Are you able to adopt in the next 30 days:
*
Tell us about what you are looking for in a new pet family member (age, sex, activity level, personality):
*
Tell us about your human family (adults and children living in your home or visiting regularly):
*
Tell us about your pet family (other pets you have or have had in the past, age, activity level, personalities):
*
Are all other dogs in the home spayed/neutered
Yes
No
N/A
What made you consider adopting from Take Me Home Dog Rescue:
List name and phone number of personal reference, not a relative:
*
By checking yes I understand and consent to TMHDR doing a background check. I also understand that if it is found I have been charged with animal abuse I will not be allowed to adopt a dog from the rescue.
*
Yes
No
Submit
Reset