Name:
Address:
City:
Prov:
Postal Code:
Phone:
Cell:
Email:
Names and relationships of other adults living in the home:
Do you have children? Yes No
If yes, please provide names and ages of children living in the home.
Will your dog come into contact with young children ie. grandkids, visitors, daycare. Yes No
If yes, please provide details including ages.
Does anyone in the family have allergies? Yes No
Are all family members in agreement about adopting a dog? Yes No
How did you hear of The Animal Guardian Society?
Please explain why you would like a dog.
What size of dog?
Are you interested in a particular breed? Please describe.
Are there other dogs in the home? Yes No
If yes please provide for all.
Age:
Breed:
Gender:
Are pets spayed/neutered?
If no, please explain:
Are there any other pets in the home? Yes No
If yes, please describe.
Are pets vaccinated?
If no, please explain:
Have they been treated for a contagious medical conditon recently? If yes please explain.
Are your pets currently licenced with the municipality in which you live? Yes No
How do your pets react to other dogs?
What type of dwelling do your currently live in?
Do you rent or own? Rent Own
If rented, does your rental agreement permit you to have a dog? Yes No
How long have lived at your current address?
Is your yard enclosed by a fence? Yes No
Please describe your yard and fence. ie. size, type.
If your yard is not fenced, are you willing to install fencing in order to adopt a dog? Yes No
Do you have a swimming pool? Yes No
If yes, is it fenced separately from the area the dog will have access to? Yes No
Have you owned dogs in your adult life? Yes No
What breeds and what happened to them?
Were your pets neutered? Yes No
Have you ever given an animal up? Yes No
If yes, what were the circumstances?
How long would you dog be left during a typical day?
Where will you keep your dog during the day?
Where will you keep your dog during the night?
Do you have experience in house training a dog? Yes No
Are you familiar with crating a dog? Yes No
Are you in favour of crating ? Yes No
Will your dog be tied up? Yes No
How will you alleviate boredom for your dog during your absences from the home?
Where will your dog stay while you vacation?
If the dog were to become ill, what arrangements would be made for care and supervision?
How do you feel about the following? List in order of preference:
Chewing, Drooling, Shedding, Odor, Wandering, Howling, Barking, Digging.
What circumstances would you consider giving up your dog?
Please list a veterinary reference that we may contact who knows or has known you and your animals.
Please list a personal reference that we may contact who knows or has known you and your animals.
Please describe the dog you would like to adopt. ie age, sex, activity, level, etc.
What kinds/characteristics of dogs would you not wish to consider adopting?
Would you consider a dog with special needs? Yes No
If yes, do you have experience with special needs animals? Please explain.
Please add any additional comments you may have.
Please be advised that a home visit will be required before your application can be approved. We request that all family members be present at this interview.
Are you willing to have a TAGS volunteer visit your home prior to and/or after adopting your dog? Yes No
Have you been informed about the adoption process and contract? Yes No
Have you been informed about the adoption fee? Yes No
Will you attend with your adopted dog to our training classes included in the adoption fee? Yes No
FOR OFFICE USE ONLY
Date forwarded to Adoption Coordinator:
Comments
Date Approved:
Dog Adopted:
Microchip#
Privacy Policy:
The information collected in this application is strictly for use by The Animal Guardian Society. Under no circumstances will information be given to any party for any purpose.
Check this box when you are ready to submit your information.