First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Cell Phone*

What is the name of the dog(s) that you saw on our website/Petfinder that you are interested in? Only one application is needed for multiple dogs*

What size dog are looking to adopt? Give estimated weight at adulthood. (This will help us determine the best fit for you and your family)*

Can we contact you via your provided cell phone number - via text or call regarding your application? *

What is your age?*
Choose one: 18-24 years old 25-34 years old 35-44 years old 45-54 years old 55-64 years old 65-74 years old 75 years or older

Please list age and relationship of all people living in your home (even part time), including applicant.*

What type of home do you live in: Single family, town home, apartment, farm, etc.?*

Please describe your household: Active, Noisy,Quiet, Average?*

If you rent, please give the rules governing pets and the landlord’s name and number: (By providing this information you are allowing us to contact your landlord please inform them of this call so they will speak with us) *

Do you live in any designated area that has BSL law? The banning of 'Pit," "Pit Mix," and other such "vicious" breeds designated on an HOA contract, condo, apartment or live within a county or city limits having additional restrictions or registrations for ownership of such breeds?*

Is everyone in agreement with the decision to adopt dog?*

Does anyone in the family have a known allergy to dogs? *

Is your yard fenced? *

If you live in a multi-family housing unit is there a dog area on the grounds or how far is the nearest dog park?

Do you have time to provide adequate love and attention? *

What other pets do you have (Pets name, breed, and age) *

Are your dog(s) current on Heartworm Prevention? *

Fill in the blank. Heartworm prevention is 1. not very important, 2. somewhat important or 3. very important to give year around? *

Are all the dogs in your home spayed or neutered?*

Have you every surrendered a pet? If so, why?*

Have you ever lost a pet to an accident? Explain*

What methods do you use to train your pets in simple tasks as Sit, Stay, Come, or Hush. *

Do you have a regular veterinarian or clinic? *

Veterinarian’s name: *

Clinic Name:*

Clinic Phone Number:*

Name Records Are Under: *

What is your idea of an ideal dog and why? *

Desired age: *

Desired adult size:*

Desired breed: *

Breeds you would not adopt: *

In a few words, tell us what you know about this breed.

What about this specific dog interests you?

Desired sex: Spayed Female, Neutered Male, No preference*

Regardless of the dogs age at adoption, are you willing to adopt a dog that has a partial or full need for potty training?*

Would you consider adopting: An outgoing dog? Extremely friendly, busy, smart dog*

Would you consider adopting: A hyper dog? (extremely busy, can be jumpy or barky, likely needs daily physical or mental exercise)*

Would you consider adopting: A shy dog?*

Would you consider adopting: A dog that takes daily medications(s)?*

Would you consider adopting: A dog that requires additional training? (this could be leash, crate, basic good Canine skills or other training not otherwise listed in the questionaire.)*

Would you consider adopting: A dog that requires regular grooming?*

Would you consider adopting: An older dog? (we consider "older" for this question, 7 years plus)*

Would you consider adopting: a "nippy" dog? *

Would you consider adopting: a dog that barks a lot?*

Where will the dog spend the day? (describe)*

Where will the dog spend the night? (describe) *

Number of hours (average) dog will spend alone*

Please refer to above question: if your pet will be alone more than 4-5 hours, please describe how the dog will spend the average day.*

Who will have primary responsibility for this dog's daily care? *

When the dog goes out, how do you plan to supervise it? Fenced yard, how large? *

Who will have financial responsibility for this dog? *

Would you be interested in fostering? Yes, No, would like to know more *

Name and phone number of Employer:*

By initialing here, you understand all members of Greener Days Ahead Rescue will make your safety our top priority. However, we are not liable for any injuries sustained to you, your children or animals while visiting our facility.*

Thank you for choosing Greener Days Ahead Rescue. Could you please tell us how you heard about our rescue? Thanks!