THE GRATEFUL DOG HAVEN, INC.
firstname.lastname@example.org • (561) 558-5221
Section 1: Personal Information
Section 2: Employment Information
Section 3: References
Section 4: Household Information
How many people live in your home, including you?
Current Pet Information
Previous Pet Information
Section 5: Veterinarian Information
Section 6: Other Information
Why do you want to adopt a dog?
What do you think are the MOST important responsibilities of owning a dog?
What behaviors/temperament are you looking for in a dog?
What behaviors would be unacceptable to you? How would you discipline the dog if this behavior is displayed?
Have you ever been accused or convicted of a crime against animals? If so, please explain.
Who will be the primary caregiver of the dog?
How many hours per day will the dog be left alone?
Where will the dog be kept during the day? At night?
Who will care for the dog when you are away?
What would force you to give up your dog?
Would you agree to a home inspection by a representative of The Grateful Dog Haven, Inc.?
I attest that all information provided in this application is true and accurate, and acknowledge that any false
information given may result in me being denied the opportunity to adopt this dog.
I agree to hold harmless The Grateful Dog Haven, Inc. and its representatives from any liabilities or injuries
caused by this dog, and release The Grateful Dog Haven, Inc. and its officers from any legal claim, cause or action.
Thanks for submitting your application!
Please allow up to 48 hours and we will get in touch with you.