ADOPTION APPLICATION

SDRO rehomes older dogs


If you prefer to mail in this information, you can print a copy of our adoption form (pdf file).

* = required fields. All questions need to be answered, even if N/A is the answer.
Name of the dog you are applying to adopt *
Breed of the dog you are applying to adopt *
Your Information
Your Name *
Street Address *
City *
State *
Zip Code *
Email Address *
Home Phone (with area code) *
Cell Phone (with area code) *
Work Phone (with area code) *
About Your Home
How long have you lived at your current address? *
Do you rent or own? * Rent    Own
If you rent, please provide your landlord's name and phone number:
Number of adults in home *
Number/ages of children in home *
About Your Dog
Who will be the most responsible for the care of your dog? *
Will your dog be around children other than those living in the home? * Yes    No
If yes, what ages?
Do you have a securely fenced yard for your dog? * Yes    No
If yes, give the type and Hheight of fencing
How many hours a day will your dog be left without a human present? *
Where will your dog stay when you are gone? *
Where and how will your dog be exercised each day? *
Where will your dog sleep at night? *
What do you plan on doing with your dog when you are gone overnight? *
Do you travel often? * Yes    No
Your Other Pets
Do you currently have other pets? * Yes    No
If yes, please list type/age/sex:
Are all of your pets up-to-date on their vaccinations? * Yes    No
Are they all spayed/neutered? * Yes    No
If not, why not?
Have you owned dogs previously? * Yes    No
If so, what breeds?
Have you ever surrendered or sold any of your pets? * Yes    No
If yes, please explain the circumstances:
Adoption Questions
Current or past veterinarian's name and phone number. * Vet's name and phone number.
Are you able to spend at least $1000/year for food and routine medical care for your pet? * Yes    No
Has anyone in your immediate family/household ever been convicted of a charge related to cruelty to animals or child abuse? * Yes    No
What is your primary reason for wanting to adopt this particular dog?*
How did you hear about this dog? *
Signature *
Date *

Thank you!


By submitting this application, I certify that all of the information I have provided is true and complete to the best of my knowledge.


We reserve the right to refuse any applicant. Thank you for taking the time to complete this Adoption Application which helps us to make the best possible placement for all concerned.

 
Have questions? Contact SDROregon@gmail.com.