Dog Adoption Application
Thank you for your interest in adopting a rescue dog with Last Hope K9 Rescue. To ensure the
best possible placement of our rescue dogs and in order to determine the proposed adoption is
in the best interest of the animal, you and your family, our application asks a number of detailed
questions.
All information will remain confidential. If you have any questions please call us at (978) 2553319 or email us at [email protected]
Please allow up to one week for processing. Finding the perfect match between adopter and
dog is our most important goal. Thank you for your interest in saving a shelter dog!
Full Name:
Age: **Note you must be at least 21 to
adopt from Last Hope K9
Rescue
Address: (including city, state, zip)
Phone:
Email:
Spouse Name
Spouse Phone:
Spouse Email:
Employer:
Years of Employment:
Work Phone
Please list two personal references and their relationship to you
Name:
Name:
Address: (including city, state, zip)
Address: (including city, state, zip)
Phone:
Phone:
Email:
Email:
Relationship to you:
Relationship to you:
Your current veterinarian
Name:
(list veterinarian you intend to use if no current pets)
Phone:
Address: (including city, state, zip)
Email:
Your Home & Family
Do you rent or own?
Type of home: (apt, townhouse, single family home,
etc)
Do you have a yard and if so, is it fenced in?
If renting, do you have landlord permission for pets?
Any breed/size restrictions by landlord or community?
(If so, please list)
Please list landlord name/address/contact info
Are there children in the home? If yes, please list ages
and any pet related allergies or issues/concerns
How many adults are in the home?
Are all members of the household in agreement on
adopting a dog?
How many hours per day would the dog be left alone?
Do you agree to a home visit as part of the application
process?
In the event of an emergency, who would care for your
dog?
Who will care for the dog when you travel?
Please describe the kind of dog you are interested in adopting
Name (if specific dog in mind):
Age/Sex/Size:
Breed/mix:
Reason for breed preference (if any):
Dog Temperament (i.e. active, laid back, etc):
Would you consider senior or special needs
dogs?
Would you consider two dogs if a bonded pair
that had been together their whole lives?
Are you committed to allow for a reasonable
adjustment period for house training, obedience,
etc?
If your new dog is not housebroken, are you
prepared to train him/her?
How will basic obedience/training be done?
How will you discipline your new dog?
Can you commit to care for the dog for its whole
life? (including standard veterinary care,
obedience or other training, emergency vet care,
etc)
Are there any behaviors/ tendencies you will not
tolerate from a dog? Please list
Please tell us a little about why you want a dog?
Where will your new dog sleep?
Will your new dog be allowed off-leash? (If so,
please explain under what circumstances)
Your current pets
Do you have any pets currently?
If yes, please list names, breeds, sex, ages:
Are your pets up-to-date on vaccinations?
Are your pets spayed/neutered?
Are your pets on heart worm preventative and
flea/tick preventative?
Do you current pets have any behavioral
issues? (i.e. dominance, food aggression, etc)
If no pets are currently in the home, have your
owned any dogs in the last 10 years?
Please list names, breeds, sex, ages of
previous pets:
What happened to them?
Where did you get your past and/or current
dog(s)? (i.e. breeder, shelter, store)
Have you ever surrendered an animal?
If so, please explain why:
What circumstances might justify surrendering
a dog?
If for some reason you had to move and could
not take your dog, what would you do with
him/her?
Is there anything else you would to like share with us about bringing a new dog into your family?
I have filled out this application honestly and to the best of my ability. I understand that an
omission of information and/or failure to answer all questions on this application can result in a
declination for adoption. I understand that Last Hope K9 Rescue can annul and reclaim the
animal if omissions or untruths are discovered after the adoption.
Signatures: ________________________________________ Date: _________
Printed Names: ___________________________________________________