Adoption Form Which dog are you applying for: *First Name *Last NameEmail Address *Phone *0 / 10Street Address *City *State/Province *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweWhat's Your Occupation? *Housing Situation *OwnerRentingAre you allowed to have dogs in your home? *YesNoAre there children living in your home? *YesNoDog Living Conditions *Indoor OnlyIndoor/OutdoorOutdoor OnlyWill your dog be allowed on furniture? *YesNoDo you have other pets? *NoneCat(s)Bird(s)Dog(s)Reptile(s)Rodent(s)Is your yard shared? *YesNoIs your yard fenced? *YesNoPartiallyDo you have a swimming pool? *YesNoWhat kind of Training do you have experience with: *Crate TrainingPotty TrainingObedience TrainingNonHow often are you home each day? *1-5 hours6-12 hours13-24 hoursI would like my dog to be *Enjoys being held / carriedSits in my lapCalm / relaxedMedium energyActive / PlayfulGets along with dogsPlays with toysQuietBe social with everyoneGets along with catsSleeps with meGets along with childrenMy dog needs to adjust to new situations quickly: *Not importantSomewhat importantVery importantI certify that the above information is true and correct to the best of my knowledge. I further agree that any adoption made on the basis of this questionnaire is null and void if any of these statements are untrue. I understand that Pets Sanctuary and animal rescue's main concern is that all pets be properly cared for by their owners. I understand the minimum adoption donation for dogs over 5 months are $200. Puppies (up to 5 months) are $400. Dogs over 10 years are $100 -- certain breeds may be at the discretion of Pets Sanctuary. Some adoption prices vary. These fees are necessary to offset the costs incurred related to rescue, care and adoption. I understand that Pets Sanctuary reserves the right to deny adoption of any animal. *Send Message
