<p> Tri-Valley Animal Rescue DOG Adoption Application</p><p>Name of dog you’re interested in:</p><p>Family Information Name: Driver’s License #: Address: City/Zip: Is the residence address listed above the location where your new dog will be living? Yes No Phone: home work mobile Email: Names and ages of others in household Why are you getting a dog? Is everyone in your household in favor of adopting a dog? Housing: Own Rent Live with parents Type: House Condo Apartment Mobile home What is your household activity level? Low Moderate Active Very active</p><p>If you rent your home the following is required: Landlord’s name: Phone: Is your landlord aware that you may be adopting a dog, and have they approved it? Yes No</p><p>If you currently own any other pets, the following is required: Please list any other pets that currently live with you, including age, species/breed, sex, and if they are altered.</p><p>Has(Have) your current dog(s) been introduced to the dog you are considering adopting? Yes No</p><p>Dog Living Arrangements and Care Will the dog be: Indoors Outdoors Indoor/Outdoor Dog run Where will the dog sleep? Inside Garage Outside Other (explain) Who will be responsible for feeding the dog each day? How many hours per day will the dog be alone? 0- 2-4 4-6 6-8 Over 8 2 Where will the dog stay when you are not home? House Garage Outside Other (explain) Will the dog be left unattended with children? Yes No If yes, please explain Who will take care of your dog while you are on vacation? If you must re-locate, what will you do with your dog?</p><p>Most dogs require regular exercise. Who will provide this? In what family activities will your dog be included? What activity level would you like your dog to have? Low Moderate Active Very Active</p><p>Are you getting a dog for protection? Yes No If yes, please explain</p><p>Is anyone in your family allergic to pets? If so please describe Do you have a fenced yard? Yes No If yes, how tall is the fence in feet? Does the fence need repairs? Yes No If yes, please explain Will you chain the dog in the yard? Yes No If yes, why/how often? Would you agree to having your property inspected to make sure it’s safe for your dog? Yes No</p><p>How will you prevent the dog from getting fleas? What type of identification will your dog wear? ______</p><p>Dog Specifications Is this dog a gift? Yes No If yes, who is the dog for? Have you (or the recipient if the dog is a gift) ever owned a dog before? Yes No What happened to the dog? Deceased Lost Gave away Other (explain) Tri-Valley Animal Rescue DOG Adoption Application</p><p>Dog Specifications (cont’d) What breed(s) of dog interest(s) you? Are you familiar with the(se) breed(s)? Yes No What age(s) interest(s) you? Puppy (<1 yr) Young (1-3 yrs) Adult (3-8 yrs) Senior (> 8 yrs) What size(s) interest(s) you? Sm (<30lbs) Med (30-65lbs) Lg (65-120lbs) Giant (> 120lbs) What coat types are acceptable? Long Medium Short Regular grooming required is OK</p><p>Training Have you ever attended a dog or puppy obedience class or a behavioral class? Yes No If yes, please list the classes and dates you attended them Do you plan to take your dog to an obedience class? Yes No If no, why not? Who will be responsible for training your new pet? What techniques and equipment will you use to train your pet? How do you plan to socialize your dog?</p><p>Please describe what you would do if your dog develops any of the following behavior problems: barking, chewing, digging, aggression, inappropriate urination in the house</p><p>Costs There are ongoing costs associated with owning a dog. Are you willing and financially able to provide the following for your dog for its entire life? (Note: costs provided below are average costs. Your actual costs may be higher or lower) $60-$150 FOR INITIAL VET CARE; $50 -$200 for initial obedience training; $25-$100 + per month for food; $150 + for yearly veterinary care and vaccines; $20 + for annual county licensing fees; $500 + for special vet care needs. I understand that my dog will cost on average $800 to over $1,100 or more per year Yes No</p><p>If the dog needs to be returned, the adoption donation may be refunded with the first two weeks, depending on circumstances. Please note that space may not be immediately available with the original foster or an alternate foster and you, as the owner, may need to foster/board the dog until we can find a new home for it. Please acknowledge your understanding Initial Date</p><p>References May we contact your veterinarian for a reference? Yes No Veterinarian’s name: Phone: If no, why not?</p><p>Acknowledgement of Responsibility Adopting a dog is a tremendous responsibility. You will be sharing your life with this dog for up to 15 years or more, and during this time the dog will be completely dependent on you for food, shelter, cleanup, and veterinary care. Please initial each of the statements below indicating you accept them.</p><p>I am/We are ready to make a LIFETIME commitment to our new dog I/We will give our dog daily companionship, and not just when it’s convenient I/We understand that if we return the dog, we will be responsible for its care until a new home is found I/We are willing and financially able to care for the dog as described in the Costs section above</p><p>Signature: Date:</p>