Puppy Love ME
Got the love to adopt a new member of the family? Puppy Love ME Adoption Application Form will help you apply and foster the new member of the family!
Name of Desired Dog
What attracts you to this dog?
Are you willing to consider other dogs if the dog you applied for is unavailable or not a good match for your lifestyle?
Your Name (must be at least 23 and head of household)
Street Address Line 2
State / Province
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
Central African Republic
Cocos (Keeling) Islands
Democratic Republic of the Congo
Turkish Republic of Northern Cyprus
Papua New Guinea
Republic of the Congo
Saint Kitts and Nevis
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
Tristan da Cunha
Turks and Caicos Islands
United Arab Emirates
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Home Phone Number
Cell Phone Number
Best time to contact you
How Did You Hear About Puppy Love Inc?
Place of Employment
Work Phone (will use only in case of emergency)
List all members of your household (names and ages), humans and animals, including yourself and all current pets. Please indicate if pets are spayed or neutered. NOTE: We do not adopt to families with children under the age of 5.
List any circumstances your rescue dog will come into contact with young children
Have you surrendered, sold or given away a pet?
If yes, please explain
How did you acquire your current pets?
Do they live indoors?
If not, explain
Why do you want to adopt a dog?
Please list any preferences (size, energy level, age, sex, breed, personality) so we can match a dog to your lifestyle
Other information you would like to share about your household including lifestyle, activities in which your dog will be included, etc
Have you submitted an application with another organization for a dog at this time?*
*Please note that it takes time and effort to process your application. If you have adopted elsewhere or changed your mind, please notify Puppy Love so that we may move forward with another applicant.
If yes, explain
Have you ever had an application declined for adoption of an animal from an animal welfare group/animal control facility?
If yes, explain
Are you willing to take the time to house train a dog, and do you understand that even the best trained dog can regress with the stress of transition to a new environment, new lifestyle, etc
Describe your level of commitment and method to change any behavioral issues that may arise with your rescue dog
Does any member of the family have any allergies to animals?
If yes, explain
Describe the kinds of personal situations where you might have to return your adopted dog to Puppy Love (i.e., job loss, children, move, marital change, etc).
Have you made provisions for your dog in the event you are incapacitated by accident, long term illness or death?
Who will be responsible for feeding, caring for, training and exercising the dog?*
*Please note that while children can be wonderful companions and caretakers, a child cannot be totally responsible for a pet's care.
Who will take care of the dog in the absence of the primary caretaker?
What training method will you utilize as your dog settles into your family and new environment?
Will you take your dog to obedience training?
How long will the dog be left unattended daily?
What pets have you owned in the past five years? List all, including ages, spayed/neutered, indoor or outdoor, and explain why you no longer have them, including causes or circumstances of their death(s) or surrender:
List all vet/animal hospital(s) where your pet(s) receives or received care*. Include the name of pet and veterinarian / animal hospital name(s) and phone number. If you do not currently have a vet, list where you intend to take your pet(s).
*In order for us to process your application, please notify your vet and authorize them to provide a reference and release information on your behalf.
Under what owner name(s) are records listed:
Explain reason(s) your pets may not be up to date with vaccines or unaltered:
Brand of heartworm prevention & schedule of use:
The costs of maintaining a physically and emotionally healthy pet are not limited to annual shots and food. Annual costs to care for your dog can easily exceed $1,000 annually. Have you considered the extra expenses that will come with having a dog, including routine and emergency vet care, heartworm prevention, flea & tick prevention, food, supplies and equipment, toys, training, licensing and boarding?
Adopters should be aware that rescue dogs may have unknown medical backgrounds.
What will you do if your pet requires extensive and/or expensive medical attention?
Reference 1: Family reference name, not living with you
Phone Number (Ref #1)
Relationship (Ref #1)
Reference 2: Personal reference name
Phone Number (Ref #2)
Relationship (Ref #2)
Reference 3: Personal reference name
Phone Number (Ref #3)
Relationship (Ref #3)
What type of home do you live in?
Do you own or rent your residence?
Do you live with roommates?
How long at current address?
*Your application will not be processed if you rent and omit landlord information.
Landlord's phone number
Do you have a fenced yard?
If yes, what type of fence and dimensions?
If no, are you willing to install a fence?
How long will the dog be contained in the yard?
Do you intend to tie your dog outdoors?
Overhead runs / prolonged periods of tying a dog outdoors unsupervised can cause injury or death.
Explain situations your dog is allowed to run free?
How often, how long and what type of exercise will the dog receive?
What physical limitations, if any, do you have?
When you are home, where will the dog be kept?
Where will the dog sleep?
When no one is home (i.e. at work, shopping), where will the dog stay (be specific)?
If you utilize a crate, how long will the dog be crated?
How often do you travel?
What arrangements will you make for your dog when you travel?
If you move, what will you do with the dog?
Have all adult family members agreed to adopt a dog?
Please check the boxes below to indicate your agreement with the following statements:
I have read the above information carefully and have filled out this application honestly. I understand that omission of information and/or failure to answer all questions and sign the application below may result in delayed processing of the application.
I give Puppy Love, Inc. permission to verify the information provided as well as contact veterinarians and other listed contacts. Please call your vet and release them to speak with a Puppy Love representative.
If the application passes this review, I understand a home and yard visit may be requested by Puppy Love, Inc. before an adoption decision is made.
I understand the adoption decision is dependent on many factors, including but not limited to the compatibility of the family and home to the individual animal, and other applications received for this animal.
Enter name in lieu of signature
I agree to the above
Should be Empty:
Copyright 2018 JotForm Inc.