Adoption Application Contact InformationName of Dog You're Applying For: Applicant's Full Name: Spouse/Partner's Name: Applicant's Age: Occupation: Address: Years/Months lived at this address: Daytime Phone:Evening Phone:Best time to call: Email address: Family and HousingHow many adults are residing with you? How many children are in the home and what are their ages? What type of home do you live in? Single family, town home, apartment, etc. Do you rent or own? If renting, are pets allowed? Please describe your household: Active Noisy Quiet Average If renting, please provide the rules governing pets and the landlord’s name and number: (by providing this information, you are allowing Giselle’s Legacy to contact your landlord. Please inform them of this call so they will speak to us)Do you have a yard and if so, is it fenced? Do you have a pool and if so, is it fenced? Does anyone in the family have a known allergy to dogs/cats? Is everyone in agreement with the decision to adopt a dog/cat? Do you have time to provide adequate love and attention? Other PetsWhat other pets do you have (specify type and number)? Are these pets up to date on vaccinations? Have you ever had a pet euthanized? If so, why? Have you ever lost a pet to an accident? How do you discipline your pets and why? VeterinarianDo you have a regular veterinarian? Yes No Veterinarian’s name: Clinic Name: Clinic Address: Clinic Phone:(Providing Giselle’s Legacy with this information, you are allowing Giselle’s Legacy to call your vet. Please contact you vet and ask them to authorize release of information to Giselle’s Legacy)About the pet you wish to adopt Where will the pet spend the day? (describe) Where will the pet spend the night? (describe) Number of hours (average) pet will spend alone? Who will have primary responsibility for this pet’s daily care? Who will have financial responsibility for this pet? Do you agree to provide regular health care by a Licensed Veterinarian? Yes No When the pet goes out, how do you plan to supervise them? Do you plan to have the pet as an indoor pet? Do you agree to contact Giselle’s Legacy if you can no longer keep this pet? Yes No Are you willing to let Giselle’s Legacy visit your home by appointment? Yes No Would you be interested in fostering? Yes No Would like to know more Personal References:Name of First Reference Address Street Address City State / Province / Region ZIP / Postal Code PhoneRelationship (relative, friend, neighbor, etc.) Name of Second Reference Address Street Address City State / Province / Region ZIP / Postal Code PhoneRelationship (relative, friend, neighbor, etc.) All the information I have given is true and complete. This pet will reside in my home as a loved family member. I will provide it with quality food, plenty of fresh water, indoor shelter, affection, and annual physical examination and necessary vaccinations under the supervision of a licensed veterinarian.SignatureDate MM slash DD slash YYYY Untitled Untitled NameThis field is for validation purposes and should be left unchanged. Δ
