Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Driver's license number * Date of birth * MM DD YYYY Phone Number (###) ### #### Email * Do you rent or own? * Rent Own If you don't own-please provide homeowners name and number Other pets at home? * Yes No How many? List name, breed, and age Spay/Neutered * Yes No Children at home? * Yes No Ages of children Who is your veterinarian? * Is everyone in your household aware of, and supportive of you adopting * Yes No List one reference, name and number * If applicable, list name of animal you are interested in * What will you do if your newly adopted pet does not get along with your other pets for a while * Why do you wish to adopt and what makes this animal a good fit for your family * Activity level in your home * Busy/Noisy Moderate comings and goings Quiet with ocasional guest We cannot guarantee an animal to be housebroken are you equipped to train with love and patience * Yes No Dogs only-do you have a fenced in yard Yes No Will your dog be primarily Outside Inside Please check all the following that apply to your new dog Guard dog Companion Hunting dog Herding dog Family pet Other I acknowledge that I have completely read and answered this questionnaire truthfully. I understand that submitting this questionnaire does not ensure approval for adoption and that untruthful answers can result in the inability to adopt an animal from Saline Animal League * Yes Electronic Signature Thank you!
