Welcome to Adopt A Stray

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Dog Application

Thank you for considering adopting a dog or puppy from Adopt A Stray. The adoption fee is $150.00 (CASH only). This includes spay/neuter, heart-worm testing, vaccinations, rabies (age permitting), de-worming and de-fleaing.

If your application is under consideration you will hear from an Adopt A Stray representative within 48 hours. If you do not hear from an Adopt A Stray representative within 48 hours your application was not approved. Adopt A Stray reserves the right to keep confidential and not disclose the reason the application was not approved. We appreciate you understanding our policy. You must be 21 years old to apply.

* Denotes Required Fields

Contact Information

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
-

Email*

Home Phone*

Work Phone*
x

Cell Phone*

Alt Email*

*=required

List at least one reference (who is not a family member) including phone number. *

Employer

Years employed there

Drivers License # (last six digits)

In what type of home do you live*

Do you own or rent your home*

Name of Complex/Association. Are there any restrictions?

If you rent, please enter your landlord's name and phone number

If you rent, have you received the approval of your landlord to have an animal?

Yes

How did you hear about us?

Have you ever turned in animal into a shelter before? *

Yes

List the names and ages of all adults and children living in the home. *

Does it matter if the dog/puppy is housebroken?

Yes

Would there be anyone home during the day?*

Yes

If yes, who?

Where will the animal be kept when you are home?*

Has anyone in the household ever been allergic to animal hair? *

Yes

List the names, ages and types (dog, cat, rabbit, etc) of pets you have had in the past 5 years. If you no longer have these pets, what is the reason?*

Who in the household would be the primary caregiver to the new dog?*

What do you currently feed your dog?

Does your dog receive monthly dog flea and heartworm prevention?

Yes

If yes, what types of prevention is used?

Will your new pet be living indoors or outdoors?*

Inside Only	Outside Only
A little bit of both

Is your yard fenced*

What is the height of the fence*

What type of fence*

Do you have any doggie doors? *

Yes

Who is your veterinarian? Include clinic name, veterinarian, location and phone number.

Why do you want to adopt a dog/puppy at this time?

Do you have a desired Adopt A Stray dog/puppy picked out? Or what characteristics are you looking for in your new dog/puppy?*

I certify that the information entered on this applicant is true. Enter your name and date*

*=required

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they deserve a chance for a better life