First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Cell Phone

Alt Email

Select the dog you are applying for from the drop down menu. If undecided, leave blank.
Choose an animal: Ladybug

Name of other dogs you are applying for: N/A if undecided

Please list names and ages of everyone in the household:*

Do all adults work outside of the home full time?*
Choose one: Yes No

How many hours per day would your dog be left alone?*

Do you believe in crate training?*
Choose one: Yes No Only to potty train a puppy

How many hours would your dog spend in a crate?*

Do you live in a:*
Choose one: House Townhouse Apartment Condo

Do You:*
Choose one: Own Rent

If you rent - what is landlords name and contact information? (We MUST have this to process your application or you will not receive a response!)

Do you have a doggie door?*
Choose one: Yes No

Do you have a fence?*
Choose one: Yes No

Is it an electric fence?*
Choose one: Yes No N/A

If electric, is it rated for a large or small dog?
Choose one: Large Small Both

Are you adopting a pet to live:*
Choose one: Inside Outside Inside/Outside

Reason you're adopting this dog (use cntrl+select):
Choose all that apply: Watchdog Family Pet Child's Pet Hunting Gift Companion for Other Pet Other

Where do your current pets spend most of their time?
Choose one: Inside Outside

Where Will Your Pet Sleep at Night: (Specifically)?*

What brand/type food are your current pets, or will your future pet be eating?*

Are you prepared to care for a pet for up to 15 years:*
Choose one: Yes No Can't be sure

How much money are you able/willing to spend if the pet becomes sick or injured? *
Choose one: $500 $1,000 Whatever it takes to provide appropriate care

Describe the pets currently in your home, if you have none please specify that. (List ages, spayed/neutered, temperament etc) If a Pet is in the same household, but belongs to another person, we will need the Vet contact information for that Pet along with the owners name. *

If you have a roommate, have they agreed to an additional Pet in the home?*
Choose one: Yes No N/A

Owners full name that any pet is listed under:*

Vet location and Phone Number (we must have this as we will contact your vet for references) Please call ahead and give permission to release information to us if your Vet requires it, this helps to speed up the process!*

Are your pets spayed/neutered?*
Choose one: Yes No N/A

Are your pets/will your pets be regular on (use cntrl +select) :
Choose all that apply: Heartworm Preventative Flea/tick preventative Annual Vet Checks None

What do you (or will you) do with your dog when you're out of town?*

What do you think are the most important responsibilities in owning a dog?*

Describe the type of situation where you might have to give up the dog?*

For which of the following reasons would you consider giving up your dog, select all that apply (use cntrl +select):
Choose all that apply: Moving Excessive Barking Fights with other pets Medical issues New Baby Not Housebroken Allergies Divorce Kids no longer want Jumps fence Financial problems Behavior Issues Messes Up Furniture No reason I would give up my pet

Have you ever had to relinquish a pet before?*
Choose one: Yes No

If so,what were the circumstances?

What else should we know?*

SAVE Application Notes: