Dog Adoption Application How did you hear about us?*Newspaper/AdvertismentWord of mouthWebsiteFacebookInstagramEmailTwitterPrevious AdopterEventIf other please describe belowHow did you hear about us?Fill this out if you selected 'other' aboveName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Home Phone*Work PhoneCell PhoneAre you 18 years of age or older?*YesNoDrivers License or ID/Expiration*Please enter your driver's license/government ID number and expiration dateEmail* For SASF use onlyYou and Your HouseholdChildren and your home* I have children Children visit my home Children rarely visit Children's agesIf you have children in or visiting your home please provide their agesDog experience*First time ownerHave had one or twoHave had manyHave attended training classes/hired trainerLiving situation*RentOwnLive with parentsMobile home or CondoIf you selected rent or mobile home/condo please enter the pet policy belowPet policyIf you selected rent, mobile home or condo above please provide your pet policyAdoption PreferencesPet's nameInterested in a particular pet? Help us find them by entering their name here. If you reached this form from their profile page this field will be filled in automatically.Pet's IDInterested in a particular pet? Help us find them by entering their unique ID here. If you reached this form from their profile page this field will be filled in automatically.Age*2-4 months (like a toddler)4-12 months (like child/teen)1-3 years (young adult)3+ years (sensible adult)Senior or special needsNo preferenceSex*MaleFemaleNo preferenceShedding*LowMediumHighMy dog will be*Outside onlyInside onlyInside most of the timeOutside and garage only, garage at nightOutside during the day, inside nights/when homeUses dog door - access to garage onlyUses dog door - access to inside the houseWhat behavior(s) are unacceptable to you?* Difficult to distract or control when on leash May attack and cause injury to a small animal Afraid of other animals (backs away/may snap) Fearful of new people/places Protective of family/home Shy/nervous toward children Independent - doesn't really need people much Clingy - needs to have someone around often Not housetrained Other If you select other please explain belowOther unacceptable behaviorsIf you selected 'other' as an unacceptable behavior, please explain.What behavior(s) do you desire or could accept?* Very active/active Calm/Gentle/Well mannered Reserved/shy Excitable/High energy Confident Playful Pushy/Tests the limits Protective of family/home Clingy/dependent Other If you selected 'other' please explain belowOther desirable/acceptable behaviorsIf you selected 'other' under desirable/acceptable behaviors, please explain.Emergency contact person outside of your homeName* First Last Phone*Is there anything else we should know about the type of dog you're looking for?Past and present pets*Please tell us your pets' names, ages, sex, breed/type, if they're altered, how long you've had them, whether you kept them in, out or both and if you still have them and why/why not. Veterinarian informationIf you have owned any pets please provide us with your vet's informationName First Last PhoneYour signature*Type your name into this field and it will act your digital signature This iframe contains the logic required to handle AJAX powered Gravity Forms.
