Adoption Form – Electronic Adoption Form Step 1 of 4 25% Pet InformationWould you like to adopt, foster, or foster to adopt?*AdoptFosterFoster to AdoptWhat is the name of the pet you wish to adopt?*You can find the pet's name on the Adopt-A-Pet page: http://danteshope.com/petfinder/How do you plan to pay for the adoption fee?PaypalCashCheckPersonal InformationName* First Middle Last Primary Email Address* Primary Phone Number*Secondary Phone NumberAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Age*Under 2121 or olderIf under 21, name of legal guardian* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Legal guardian's phone number*Name of EmployerEmployer's Phone NumberHousing*OwnRentIf renting, check all that apply.* Dogs are allowed Dogs are NOT allowed A pet deposit is required I have already paid the required pet deposit I have NOT already paid the required pet deposit Name of Landlord or Property Manager*Landlord or Property Manager's Phone Number*How many months have you been at your current address?*If you move in the future to a place where DOGS are NOT allowed, what would happen to the dog?* Living ArrangementsWhere will the dog primarily live?*Inside OnlyOutside OnlyBothIs your yard securely fenced?*YesNoHow many adults live in your home?*How many kids live in your home?*Please list the age of each kid living in your home.*Does anyone living in your home have allergies?*YesNoIf yes, what allergies?*How many hours will the adopted or fostered dog be left home alone each day?*What role will the adopted or fostered dog play in your life?*Describe the activity level in your home:*Is everyone living in your home committed to caring for a dog?*YesNoWho will be responsible for feeding/grooming/vet visits, etc?* Behavior Issues and CostsAdopted dogs usually have some potty accidents in their new home for a short time. How will you handle this?*What behavior problem(s) would you NOT be able to live with? Barking Chewing Destruction Escaping Jumping on people Potty problems If the adopted or fostered dog has any of these behaviors, how will you handle it?*What is your estimated budget for MONTHLY care items?*Dogs require monthly medications for prevention of fleas, ticks and heartworms as well as annual visits for shots, dental care, and grooming.What is your estimated budget for ANNUAL visits?*Have you ever taken a dog to an animal shelter or to animal control?*YesNoIf you have taken a dog to an animal shelter or animal control, why was it necessary?* History and CareHow many dogs/cats have you had in your life?*When was the last time you owned a dog?*Do you have any dogs/cats living inside and/or outside your home right now?*YesNoIf yes, do you currently have dog(s), cat(s) or both living inside and/or outside of your home right now?*DogsCatsBothIf yes, how many dogs/cats are living inside your home right now?*If yes, how many dogs/cats are living outside your home right now?*Have you lost a dog to an accident or escape in the last 5 years?*YesNoIf yes, what happened?*For each dog currently living with you, what is the dog's name, breed, and does it live inside or outside at your home?*Separate each dog by name and line. Example entry: Marley - Labrador Retriever - Inside only Scooby - Great Dane - Outside during day, Inside at nightAre all dogs living at your home right now spayed or neutered?*YesNoWhere do any dogs currently living with you primarily stay?*InsideOutsideAre all dogs currently living with you potty trained?*YesNoWho potty trained your dog(s)?*Are all dogs that are currently living with you (inside & outside) up to date on their vaccination?*YesNoWhat kind of heartworm preventative do you prefer to use?*Please list your current veterinarian name and clinic:*NOTE: If you no longer own a dog, we will still need the last veterinarian and name of clinic that you previously used., the dog(s) name AND how long ago that was.Your vet / clinic's phone number:*NOTE: If you no longer own a dog, we will still need the phone # to the last veterinarian or clinic that you previously used, the dog(s) name , AND how long ago that was.