Adoption Application Dog InformationPlease enter the information about you and the dog you might want to adopt.Name of Dog to Adopt*Foster Parent*LeeannLisaSharonSheillyTammyDo you have previous experience with this breed?*YesNoWhere will the dog be during the day?*Where will the dog be at night?*How many pets do you currently have?*Have you ever raised a puppy before?*YesNoHave you had previous pets?*YesNoWhy are they no longer with you?*Applicant InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Mobile PhoneWork PhoneEmail Address* Over 21?*YesNoHousing InformationType of home?*Single Family HomeDuplexCondoApartmentOwn or lease?*OwnLeaseIf you lease, do you have permission to own a dog?*YesNoLandlord Name* First Last Landlord Phone*Fenced?*YesNoFence Height*Fence Type*Yard Size*Swimming pool?*YesNoHousehold InformationNumber of people in household*Number of adults*Number and ages of children*Hours worked per week*Is anyone in household allergic to pets?*YesNoPlease tell us more about you and your family and what you are looking for in a dog. If you have any additional comments please also add them here.*Captcha