Washout Application

This application is for dogs that have been washed out of our Shelter to Search program that are looking for pet homes.

Name

First Name

Last Name

Email

Phone

(###)

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Name of the dog you are interested in adopting.

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you rent or own your current residence?

Rent

Own

Landlord or Rental Company

If you rent your current residence, provide the name of your landlord or rental company.

Pet Restrictions

If you rent your current residence, provide any breed, size, or other pet restrictions at your current residence.

Is this your first dog?

Yes

No

Household

Please provide the names and ages of everyone that will be living with the new dog.

Current Household Pets

Please provide the species, breed, and age of any pets currently living in your home.

Have you had any other pets in the last 5 years?

What activities do you plan to do with your dog to provide a mental and physical outlet?

Where will your dog stay while you are at work, traveling, or otherwise occupied?

What kind of behaviors can you not tolerate in a dog (ex. chasing cats, chewing on valuables, etc) and how would you handle those behaviors if they came up?

Veterinarian Name

Veterinarian Phone

(###)

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