Project K-911 Dog Adoption Application

Please understand that not all families and dogs are compatible. Every effort is made to match traits exhibited by a dog with characteristics, which you desire in a dog. Our goal is to ensure the welfare of the dog only by placement in the best possible home. To be considered as an adopter you must: Be 21 years of age or older and have a photo identification Be prepared to pay an adoption fee of $125.00 - $200.00, which is non-refundable Veterinary Care: I understand veterinary care for this pet can extend ten to twenty years. I agree to provide regular and emergency veterinary care for the life of this pet. Initial here:________. Surrender Policy: In the event I am unable to keep this pet, I understand and agree to surrender them back to Project K-911 and not to any other animal care facility, person or family member. I further acknowledge the adoption fee is non-refundable and I agree to give a minimum of two weeks notice prior to this surrender so room can be made available for the return of this pet. Initial here:________.

I understand this Adoption Application will be used to verify my statements and hereby authorize Project K-911 to contact the names I provided. I further agree to a home inspection to confirm the environment is what I claim it is. I submit this application in good faith and promise to support and protect the pet I want to adopt for the rest of its natural life.

Personal Information Have you previously applied for pet adoption at any other organization? ___________ If so, which one(s):_________________________________________________________ Name Address City Home Phone Email address Number of adults living in household Ages of children Number of Children Yes No State Work Phone Zip

Does anyone have allergies? Explain if yes

Do you live in a

House

Condo

Apartment

Mobile Home

Townhouse

How long have you been at your current address? Do you Own Live with a relative Rent Phone number Yes Yes No No Landlords Name

If you do not own, do you have your landlords permission to have a pet Amount of deposit required Has this been paid?

(We will verify this information with your landlord) See next page: What restrictions on size and/or number of pets apply in your subdivision or apartment complex? Do you operate a business from home ANIMAL CARE INFORMATION Why do you want to get a dog? How long have you considered this decision? Do all adults agree to this adoption? Yes No Yes No Type

Who will be responsible for the care of this dog? Where will the dog be kept during the day? Where will the dog be kept when you go on vacation? How many hours per day will the dog be left with no one home? Where will it be kept? Will this dog spend most of its time per day? If you move in the future, what will you do with the dog? If you have to move into a building where pets are not allowed, what would you do? What type of food will you feed this pet? Can you invest the time and effort to allow the dog to adjust to a new home? Yes No Inside Outside If outside, how many hours

How long seems reasonable to adjust? If you had to give up the dog, what will you do? If the dog were lost, what would you do? If the dog requires surgery or special care, what would you do?

How many pets do you have? Type Neutered Sex Age

List the pets you have in your household Vaccines current? Kept where

List the previous three pets you have owned Type Neutered Sex Age Vaccines current?

Kept where

Have you ever had a pet die of causes other than those related to old age? If yes, explain: Have you ever returned or given away an animal before? If yes, explain What vet will you use? Phone number of vet DOG COMPATABILITY Please explain why you picked the dog you are applying to adopt. Do you want a dog for: (mark all that apply) Kids pet Companion Gift for: Other: Company for other pet Guard dog Household pet Hunting dog Yes No

Yes

No

Watch Dog Fighting dog

Outside dog Explain:

What do you consider valid reasons for giving up a dog?: (mark all that apply) Moving Chewing Fleas Destructive Biting Grew too big Digging

Vet Bills

Unable to housetrain Allergies

Having a baby Other

Barking too much

Too rough with children

What will you do if the dog demonstrates the following behavior? Digging: Chewing: Not getting along with other pets: Difficulty in adjusting to household: Destructive traits: What preferences and personality traits do you want in a dog? Breed: Size/Weight: Sex: Color: Low Hair Length: Medium High Playful

Activity Level/Traits?: (mark all that apply) Lap dog children Quiet Laid back

House trained Other (list):

Good with

Past puppy stage

Likes cats

What traits would you consider undesirable? DAILY CARE OF THE DOG Where will the dog be kept: At home At work Both Other House Kennel

How will you keep the dog confined? (mark all that apply) Fence Chain/rope Patio Crate Other:

If crated or kenneled, how many hours per day? Do you have a yard? If fenced: Type: What size yard do you have? Yes No If yes: Height: None Small

Type and size? Fenced Open

Partially fenced

Condition: Medium Large Acreage

Where will the dog be allowed to relieve itself (potty)? You will probably have to house train a puppy. Please explain your method of house training: How often will the dog exercise? Where and how will you exercise the dog? How will you transport the dog? Do you plan on taking the dog to obedience training and if yes, where? How will you prevent heartworms? Are the dogs you have on now on heartworm preventative? type? Yes No If yes, what

Dogs often live in excess of ten years. Are you prepared to assume responsibility for that long of a period Are you familiar with the following?: (mark all that apply) Bordatella Rabies Parasites Heartworms Parvovirus Distemper

In some cases we will do a home check in order to make sure the dog is suitable for your home. Would you agree to allow a Project K-911 representative to perform a home check? Yes No Please provide at least one vet reference: Name Phone number/address I certify that the above information is true and correct. I understand that false information may result in nullifying this adoption, and the organization reclaiming the adopted pet. Project K-911 reserves the right to approve or deny adoption to anyone for any reason. Our MAIN interest is the well being and proper placement of the DOG
SIGNATURE OF APPLICANT:_ ____________________________ DATE__________ SIGNATURE OF CO-APPLICANT: __________________________ DATE:_ ________ TEXAS DRIVERS LICENSE NUMBER:_ _____________________________________

Note: You will be asked to show your drivers license to adoption counselor or attach a photocopy of license to application

FOR COUNSELOR USE ONLY:

SIGNATURE OF COUNSELOR:____________________________ DATE:___________ ( ) APPROVED ( ) DENIED

. Dogs name:______________________________________Case Number:____________ Breed:______________________________________Sex:_________Age:____________ Microchip Number:________________________________________________________