Save the Strays

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone*
x

Cell Phone*

Alt Email

We are looking for adopters who will keep their dogs as companions/house pets and make them an integral part of their family. Applicants or their spouses must be at least 21 years old and financially able to take on the responsibilities and expenses of owning and caring for a dog.   

You must answer every question in this application. If something does not apply to you, please enter N/A.

ADDITIONAL CONTACT INFORMATION

Spouse/Partner First and Last name (or N/A):*

Spouse/Cell number with the area code (or N/A): *

Spouse/Partner email (or N/A):*

First and last names and relationship to the applicant of any other adults in the household (or N/A).*

First and last names of any children in the household (or N/A):*

YOUR HOME & WORK 

Are you employed?*
Choose one: Yes, Full-time Yes, Part-time No, Not employed/ retired No, Student

Spouse’s employment status (select N/A if not applicable):*
Choose one: Employed Full-time Employed Part-time Not employed/retired Student N/A

Do you own or rent your home?*
Choose one: Own Rent

If you rent, is a dog of the breed & size for which you are applying allowed?
Choose one: Yes No

Does your yard have a physical fence that is fully connected to your house? *
Choose one: Yes No

If yes, how high is the fence?

If you have a pool, pond or other body of water on or adjacent to your property, is there a safety fence to prevent unsupervised access by a pet? *
Choose one: Yes No N/A

PET EXPERIENCE

Please list the name, species, breed, age, gender, spay/neuter status and size for each pet you currently own (If none, put N/A).*

Name of veterinarian or clinic that cares for your current pets (or any pets you owned within the last 5 years) or if none, put N/A:*

Veterinarian/clinic phone number with area code:

Names, species, breeds and ages of pets seen by this vet (or N/A):*

Additional veterinarian/clinic name, if more than one:

Additional veterinarian/clinic phone number:

Names, species, breeds and ages of pets seen by this vet:

Are there any pets in your home that are NOT owned by you? *
Choose one: Yes No

If yes, please tell us to whom they belong, why are they staying with you and for how long.

Have any pets you owned in the last 10 years been rehomed or surrendered a pet to a shelter?*
Choose one: Yes No

If yes, please tell us why.

YOUR PLANS FOR A NEW DOG 

Which of our dogs are you applying for/interested in? *
Choose an animal: Dickens Gilley Miss Piggy Turk

Does everyone in the household want this dog?*
Choose one: Yes No

Which adult will be the dog’s primary caretaker (feeding, walking, training, etc.)? *

On average, how many hours a day will your dog be alone and how many days a week? *

What activities are you planning with your new dog?*

If you travel, will you take your dog with you? If not, who will care for it while you are away? *

REFERENCES  

Please provide the names and phone numbers of two personal references. These are in addition to any vet reference and should be friends, coworkers, colleagues or neighbors – NOT a relative or person who lives with you .

Name of Reference 1*

Reference 1 email: *

Reference 1 phone number with area code:*

Reference 1 relationship to you:*

Reference 2 Name:*

Reference 2 email:*

Reference 2 phone number with area code:*

Reference 2 relationship to you:*

Agreement 

Applicant attests that he/she (or his/her spouse) is 21 years of age or older and financially able to care for a dog, including providing routine and emergency veterinary care *
Choose one: I agree

Please alert your vet and personal references that they will receive a call from Save the Strays and let them know they have your permission to speak with us.*
Choose one: I understand

Please note: Submitting an application does not guarantee that you will be able to adopt from us. *
Choose one: I understand