Apply to Adopt. Prospective Adopter Information Name * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Dog(s) of Interest * Occupation/Work Schedule * Employer Name & Address * Your Home Household Members (include yourself) * Please include age and occupation of all household members Household Type * House Apartment Condo Co-op Does your home have an outdoor space? * Yes - Private Yard/Patio Yes - Shared Yard/Patio No If you answered yes above, please share if your space is fenced. If so, include fence height. Does your home have a pool? * Yes No Would you allow an inspection of your home by a rescue volunteer? * Yes No Do you rent or own? * Own Rent If you rent, what is the pet policy? * No Restrictions Breed Restrictions Weight Restrictions Breed/Weight Restrictions I do not rent. If you listed restrictions, please elaborate: * If none, list N/A Renters: List your Landlord Name and Contact Information * Owners: N/A Do you currently own pets? * Yes No Pet Information (List Name, Age, Breed, Altered, How You Obtained, How Long Have You Owned Them, If no longer with you, please explain why). * Please include current and former dogs owned. Have you ever intentionally bred a dog? * Yes No Does anyone in your household have animal related allergies? * Yes No Have you ever trained a dog? * Yes - Basic Obedience Yes - Agility Yes - Herding/Hunting Yes - Working/Guard Dog No Veterinarian Name and Phone Number * Please ensure to give permission to your veterinarian to provide a veterinary reference. Your New Dog Are you prepared to meet and adopt the dog you're applying for within the next week? * Yes - definitely! No, not yet. Ideal Energy Level * Low Medium High No Preference Ideal Adult Weight * True North cannot guarantee any dogs adult weight. Small (0-20 lbs) Medium (21-50lbs) Large (51-100 lbs) No Preference If the dog grew larger than anticipated, are you prepared to keep the dog? * Yes No My Ideal Dog is * Housebroken Crate-trained Some Basic Obedience No Preference It's important my dog gets along with: * Check all that Apply. Dogs Cats Toddlers (under 5) Children (5+) People w/Disabilities (Wheelchair bound, etc). No Preference Who will be responsible for the care of the dog? * Other than Primary Applicant, please list others who will partake in daily care of the dog. What is your primary reason for adopting the dog? * Where will the dog sleep? * In a Crate In a Dog Bed In My Bed In Another Room How many hours a day will the dog be alone? * 0-2 3-4 5-6 7-8 8+ Will you utilize any of the following? * Dog Walker Doggy Daycare Friend/Relative Check In None Where will the dog be when left unsupervised? * In a Crate In a Gated Area Free Roaming Do you plan to allow your dog outside unsupervised? * Yes No How do you plan to handle your dog's exercise needs? * Walks Dog Parks/Runs Running Biking Hiking Agility At times, dogs may exhibit behaviors that may require additional training. Are you prepared to provide a trainer for your dogs needs? * Yes No How often do you travel? * 0-1 time per year 2-4 times per year 5+ times per year If you travel, please describe the care plan for your dog during your travel. * If your dog becomes destructive at your home, what would you do? * If your dog has accidents at your home, what would you do? * If your dog shows separation anxiety, what would you do? * If your dog becomes aggressive to people, what would you do? * If your dog becomes aggressive to other dogs, what would you do? * If the dog becomes ill or injured, are you financially prepared to provide the medical care? * Yes No The dog may live for 15+ years. What would you do with your dog if you could no longer care for them? * Is there anything else you would like to tell us about yourself or your family? References Reference #1 * Reference Name, Relationship, Phone Number Reference #2 * Reference Name, Relationship, Phone Number Reference #3 * Reference Name, Relationship, Phone Number Thank you for choosing to adopt! Dogs have a way of finding the people who need them, and filling an emptiness we didn’t know we ever had. Thom Jones
