Katys Dog Place

ADOPTION APPLICATON
(Please complete and email or print & bring with you)
Name: __________________________ Phone #: __________________________
Address: __________________________ E-Mail: _________________________
Best time to contact: _________________________________________________
Interested in (name of dog or specifics of the dog you want):
___________________________________________________________________
___________________________________________________________________
Why do you wish to adopt a dog? ______________________________________
___________________________________________________________________
___________________________________________________________________
Do you: Rent? ______ Own? ______
-if rent, do you have written permission to obtain a pet? ________
Landlords name and phone number: __________________________________
___________________________________________________________________
May we contact your landlord? YES: ________ NO:__________
Veterinarian (Name, address and phone number):
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
May we contact your veterinarian? YES______ NO________
Family members (Names and Ages)

__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Family pets (Species, age, spayed/neutered)

__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

Do you have any livestock? (cattle, horses, chickens,etc) If yes please list:
_____________________________________________________________________________
______________________________________________________________________________
Daily time with dog: _________________________________________________
Work Hours: _______________________________________________________
Activities interested in: _______________________________________________
__________________________________________________________________
__________________________________________________________________
Do you have a fenced yard in good condition: YES _______ NO_______
What type and height? _________________________________________________
Size of yard: _________________________________________________________
Pets living quarters: _________________________________________________
___________________________________________________________________
Previous Pet history (past pets and reasons for no longer having them):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Do you understand that adopting a pet is a commitment of 10-15 years or more?
YES_______ NO________
Do you commit to obtaining proper medical care and upkeep of vaccinations and heart worm
preventive? YES_______ NO _______
Do you understand that dogs are part of the family and should have access to living in the house
and becoming a family member?
YES__________ NO_______
Have you adopted a pet from a shelter or rescue group before? If yes, please give details and
name of shelter/rescue:
YES_____ NO__________
Shelter/Rescue:_________________________________________
Details:___________________________________________________________________________

Please return application to ilovemutts@aol.com

***Thank you for your interest in adopting a RESCUE dog! One of our volunteers
will contact you soon to continue the adoption process. ***
Any additional information you would like to provide, or questions you may have: