Adoption Application

Dog interested in: *

Name of Applicant *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Cell Phone Number *

Email *

Ages of all adults and children living at your house: *

Other pets, ages and whether or not they are spay/neutered: *

If no current pets, please list others you have recently owned and what happened to them: *

Name and phone number of current vet: *

Please list a personal reference other than a family member: *

Is your yard fenced? *

Yes No

If not, how will you insure it's safety while outside? *

Will the dog live indoor or outdoor? *

How long daily will the dog be left alone? *

Where will the dog stay when you are away from home? *

Please tell us why you want a dog: *

Please tell us a little about your lifestyle and your family including any special activities in which your dog would be included: *

Woodruff Co. Animal Rescue Friends