Adoption Application Step 1 of 5 20% This is not a test and completion of this document does not imply a guarantee of approval for adoption of any Pooch Match animal. Please answer each question completely. Do not skip any questions. If there are questions that do not apply, please enter not applicable (N/A). Completion of the application, in entirety, is required in order for us to review your application for approval/denial.Name of the dog(s) you are interested in (if multiple, please specify ‘and’ / ‘or’):*Your Name* First Last Age*Phone*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Occupation*Employer*Years with Employer* Breed of dog you seek*Age of dog you seek*What sex are you looking for?*Female onlyFemale preferred, but male would be okayNo preferenceMale preferred, but female would be okayMale onlySize of dog you seek* Select All Toy (under 10 lbs) Small (10 - 25 lbs) Medium (25 - 50 lbs) Large (50 - 80 lbs) Activity Level Preference*How much physical & mental stimulation do you want to give your dog?Low (house pet)Medium (weekly walks)High (daily walks/jogging pal)Please describe the characteristics you find important in the dog you adopt:*Please describe the characteristics you DO NOT want in the dog you adopt:*What will you do if your dog has some unwanted characteristics?*How sociable do you want your dog to be with strangers?*Are you looking for a dog who is comfortable in a social setting (dog parks, dog beaches)?*YesNoWould prefer it, but not necessaryNo preferencePlease describe the energy/activity level of your household, in general:*Do you own or rent?*OwnRentType of residence*HouseApartmentCondominiumDo you have permission from your landlord to have a dog/puppy?*YesNoLandlord's Name* First Last Landlord's Phone*Do you live in a two-story home or in a second-floor apartment?*YesNoIs there a patio?*YesNoIs the patio enclosed?*YesNoHow is the patio enclosed?*How high is the enclosure of your patio?*Are there any gaps at the bottom of the enclosure?*YesNoHow large are the gaps?*Is there a balcony?*YesNoHow is the balcony enclosed?*How high is the railing of your balcony?*Are there any gaps at the bottom of the railing?*YesNoHow large are the gaps?*Do you share your yard with anyone else?*YesNoDo you have a fenced yard?*YesNoWhere and how often do you plan to take your dog to potty?*What type of fencing do you have?*How high is your fence (at the lowest point)?*How high is your gate?*Do you have a pool?*YesNoIs there a fence around the pool?*YesNo How many adults in your household?*Please list their names, ages and occupations:*NameAgeOccupation Does everyone in your household want to adopt?*YesNoDo you have children?*YesNoWhat are their ages?*Is anyone in your household allergic to pets?*YesNoWhat type of pet causes the allergy?*Where will you keep your dog?*Indoors OnlyOutdoorsIndoors/OutdoorsWhen will the dog be outside?*When will the dog be inside?*Where will your dog sleep at night?*Do you have a dog door?*YesNoWill you install one?*YesNoWhich rooms are off limits to your dog?*Is the dog allowed on the furniture?*YesNoWhen you are not at home, where will your dog be?*Is anyone home during the day?*YesNoHow many hours will the dog be alone on average per day?*Does anyone come on your property (gardener, pool cleaner, housekeeper, etc.) while you’re not there?*YesNoWhere will your dog be during those times?*When you go on vacation, who will care for your dog (select all that apply)?* Housesitter Friend Vet/Boarding Other Do you have any current pets?*YesNoList current petsAgeBreed (estimation)Weight (estimation)Male/FemaleSpayed/Neutered/UnalteredUp-to-date on vaccines?Kept indoors/outdoors/both Other information about current pets?Do you have any former pets?*YesNoList former petsAgeBreed (estimation)Male/FemaleSpayed/Neutered/UnalteredKept indoors/outdoors/bothReason not in possession Other information about former pets? Have you ever lost a dog?*YesNoHow?*What will you do if your dog gets out? Please elaborate.*In the past, have you ever been forced to give up your dog?*YesNoReason(s) you could not keep the dog?What did you do?*Gave to relativeGave to friendGave to adoption groupTook to animal shelterFound the dog a new home through newspaperWhat will you do if you can no longer keep your pet?*What will you do if your dog gets sick?*How much do you think vet care will cost?*Are you prepared to spend the money, if needed?*YesNoDo you have a veterinary spending limit?*YesNoExplain the limit:*Do you currently have a vet?*YesNoVeterinarian Name*Veterinarian Phone Number* A pet requires a lot of attention. Are you prepared to spend a lot of time with your new pet (for the rest of it’s life)?*YesNoWhat will you do if your dog/puppy chews on your favorite shoes or furniture?*What if he/she has accidents on your carpet?*How will you get your dog/puppy to do what you want it to do?*Have you ever trained a dog/puppy in obedience class?*YesNoDo you still use those same training methods?*YesNoDo you think it is necessary for your dog to wear an ID tag?*YesNoDo you think it is necessary to maintain updated contact information on your dog’s microchip?*YesNoUnder what circumstances will you give up your dog? (Check all that apply)* Allergies Dog barks a lot Dog digs in yard Big vet bills Dog loses control of bladder Dog develops chronic illness Dog is not what I expected Dog nips at strangers Dog nips/bites kids Dog is not active enough Dog is too active Dog sheds too much Dog is too shy Dog is too outgoing Dog cannot go to dog parks Dog doesn’t get along with my dog(s)” Dog doesn’t get along with my cat(s) Other Explain*If dog were to do one of the above behavior issues (nipping, biting, barking, digging, etc.), will you be willing to consult a trainer (to try to rectify the situation) before giving the dog up?*YesNoExplain:*Are you prepared to make a commitment of 15 to 18 years to this pet?*YesNoPlease provide two personal references (no relatives)*We will not contact your references without letting you know first. NamePhone NumberYears Acquainted If you have pictures of yard and home, you can add them here (photos cannot exceed 50 MB.) Drop files here or Accepted file types: jpg, pdf. Additional notesIf you have any additional notes, please enter them here.User Consent* I agree to the terms listed below.Adult dogs may be returned within 10 days for a full refund. Puppies may be returned within 10 days for an all but $100 refund of the adoption fee. After 10 days there is no refund to the adopter. The adoption fee is a tax-deductible donation.Consent* I agree to the terms below.If applied and approved for a puppy, he/she must have all core vaccines and be spayed/neutered no later than 7 months of age and will not be used for breeding, as is required in the Poochmatch adoption contract.We reserve the right to refuse any adoption that we feel will not suit the dog’s/puppy’s requirements. Dogs/puppies are fun, loving, playful, and a lot of work. Please be sure that you can make a commitment to the care of the dog/puppy before you decide to adopt one.CommentsThis field is for validation purposes and should be left unchanged.