5 Adopt a Puppy

Ontario Residents Only please...

Date *

- Month - Day Year

Name *

First Name Last Name

E-mail *

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone Number *

- Area Code Phone Number

Cell Phone

- Area Code Phone Number

Work Phone

- Area Code Phone Number

Are you interested in adopting a dog to help support you or someone in your household as a companion? *Note: companion dogs do not have public access.

Have you or your family had any experience with crate training a puppy/dog? *

Yes No

Have you or your family had any experience with obedience training a puppy/dog?

Yes No

Have you or your family had any experience with raising and or resculng an older puppy/dog? *

Yes No

Do you currently own a dog, or have you owned a dog in the past 5 years? *

Yes No

If No, have you had a dog in the past? Please describe when.

Please list the dogs you own or have owned in the past. Include breed, activity level, gender (spayed or neutered): *

Do you currently have any dogs or pets in the home? *

Yes No

If you do not have any dog(s) in the home please explain why or explain what happened to the dog(s)

Does anyone in your home have allergies to dogs/cats? *

Yes No

Are there any special considerations you have in adopting a dog? *

How many people currently live in your household? *

How many adults and how many children? What are the age groups of the children? *

Are dogs permitted where you live? *

Yes No

Do you own or rent your home? *

Own Rent

Please describe your home (check appropriate boxes) *

Detached Semi Detached Townhouse Apartment

Check type of yard you have *

No yard Small yard Large yard Acerage

Is the yard: *

Fully fenced Partially fenced Open Invisable fence

How many hours would the dog be left unattended during the day? *

Is there someone able to relieve and exercise the puppy through the day? *

Yes No Possibly

Where will the dog stay when you are not home? *

Crate Will have run of house Outside In a dog run outside In a room in the house In the basement In the garage Other

Do you have any dog training experience? *

Yes No

If yes, please describe your experience

Describe the type of dog you would like to adopt: *

Where will the dog stay when you are home? *

Describe the type of activity level you are looking for in a dog? *

List some of the things you would like to do with your dog: *

Do you have a preference in the breed or gender of the dog? If so please explain. *

Are you prepared to accept the responsibilities associated with adopting a dog that has special needs or health issues? *

Yes No Maybe, depending on condition

I understand that being a responsible dog owner maeans making the commitment to caring for the dog for the rest of its life, and that the dog can live to approximately 15 years of age. *

Yes No

How did you hear about ADS?

References. *

Enter the message as it's shown *

5 Adoption Application Form