Adoption Application
Questions marked by * are required.
1.	Name: *
2.	Pet Applying for:
3.	If not a specific pet, what breed or age of pet are you looking for?
4.	Street Address: *
5.	City: *
6.	State: *
7.	Zip Code: *
8.	Phone Number: *
9.	Email: *
10.	Employer: *
11.	Do you rent? * Yes No
12.	Is there a pet policy? Yes No
13.	Name & Contact for Landlord:
14.	Children in the home? Please list ages if yes. *
15.	Is anyone home during the day? * Yes No
16.	How many hours daily will the pet be left alone? *
17.	Where will pet be when no one is at home? *
18.	Is shelter provided for outside? *
19.	Do you have a fenced yard? * Yes No
20.	If yes, what type and height of fence? (i.e. 4' chain link, 6' privacy)
21.	Are you aware of the need for heart worm prevention? * Yes No
22.	Please list breed and ages of current pets: *
23.	Are current pets spayed/neutered? *
24.	Are pets current on vaccinations?
25.	Are pets current on heart worm preventative?
26.	Name and contact for veterinarian? *
27.	Are you aware that adjustment periods can take up to two months? * Yes No
28.	Are you aware that pets can have behavior problems? * Yes No
29.	Do you have the time, responsibility and resources to give proper care and guidance to ensure a happy and healthy pet for its lifetime? * Yes No
30.	Are you willing to submit to a representative from AGD doing a home visit prior to finalization of adoption? * Yes No
31.	Personal reference #1. Name, phone contact and relationship to you: *
32.	Personal reference #2. Name, phone contact and relationship to you: *
33.	Signature of Applicant: *