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Adoption Application
Adoption Application for Grand Paws Senior Sanctuary
Please fill out this form completely; failure to answer one or more questions may result in your application being rejected. Completion of this application does not guarantee adoption of a Grand Paws Senior Sanctuary dog.
Please note: all fields are required.
Your Name
*
First
Last
Name of Desired Dog
*
Your email
*
Daytime phone
*
Evening phone
FAX
Your home address
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Type of dwelling
*
House
Condo
Apartment
Do you rent or own?
*
Rent
Own
Your Occupation
*
Partner/Spouse's Name
First
Last
Partner/Spouse's Occupation
Name/ Ages of Children, if any
Any other occupants in your home?
Please indicate your age group
*
18-21
22-26
27-32
33-45
46-55
56-70
71+
Who is more the "dog person" in your household?
*
If you have children, please describe their previous experience with dogs.
At what age do you feel children are responsible enough to take care of a dog without assistance (i.e., walk, feed, etc.)?
*
Is anyone in your household allergic to dogs?
*
What percentage of time with the dog be in the house?
*
What percentage of time with the dog be in the yard?
*
Which rooms, if any, will be off limits to the dog?
*
Is the dog allowed on the furniture?
*
Yes
No
Where will the dog sleep at night (be specific)?
*
When you go to work, where will the dog be?
*
House
Yard
Do you have a doggie door?
*
Yes
No
Is anybody home during the day?
*
Yes
No
Who will be home during the day?
About how many hours will the dog be left alone?
*
Who has access to your yard? (Check all that apply)
*
No one has access
Family members
Gardener
Pool man
Utility workers
Neighbor
Other
Where will the dog be while they are working?
Do you have a housekeeper who enters your home when you are not home?
*
Yes
No
How long have you had this housekeeper?
Does your landlord have a key to your house?
Yes
No
Does your landlord have a key to your gate?
Yes
No
Do you share your yard with other tenants?
Yes
No
What outside areas are available to the dog? (select all that apply)
*
Fenced yard
Enclosed patio
Garage
Dog house
Unfenced common area
Other
Please describe the other area(s)
*
Please describe the type of fencing around the yard. (Chain link, wood, block wall, etc.)
*
What the highest point of the fence (measured in feet)?
*
What the lowest point of the fence (measured in feet)?
*
Please enter a number from
0
to
12
.
What the lowest point of the gate (measured in feet)?
*
Please enter a number from
0
to
12
.
Which of the following is used to secure your gate?
Latch
Keylock
Deadbolt
Padlock
Other
How is your gate secured?
If your dog has gotten out, which of the following did you do?
*
Check shelters
Put up signs
Put ads in newspapers
Flyers door to door
Wait, because my dog may come back
Other...
What other thing would you do to find your dog?
What brand of food will you feed your dog?
*
Will you feed your dog "people food?"
*
Yes
No
What kind of "people food" will you feed your dog?
Who, in your house, will be mostly responsible for feeding the dog?
*
How many times per day will you feed the dog?
*
Once
Twice
Three times
What do you think is a good way to keep your dog's teeth cleaned?
*
Never really thought about it
Do it myself
It's not necessary
Feed it dog biscuits
Have the vet do it
Which of the following will you use for flea control?
*
Flea sprays
Flea baths
Flea collars
Herbal flea collars
Flea Busters
Flea comb
Frontline or Advantage
Other...
What other method of flea control will you use?
Have you ever trained a dog in obedience class?
*
Yes
No
What training methods did you use?
Do you still use these training methods?
Yes
No
What method do you use to housebreak your dog?
*
In which of the following situations are you able to have your dog off leash?
*
Park
Hike
Beach
Neighborhood walk
My front yard
Other...
In what other situations will you be able to have your dog off leash?
What discipline will you use if your dog chews your favorite shoes?
*
Which of the following disciplines will you use if your dog just won't listen and is really naughty?
*
Spank with hand
Spank fanny with newspaper
Swat nose
Stern voice
Scruffing
Other...
What other method of discipline will you use?
When will your dog wear a choke chain?
*
Never
Always
Only on walk
Do you think it's necessary for your dog to wear an ID tag?
*
Yes
No
What kind of ID Tag(s)?
Vet / Rabies
LIcense
With phone#, name, address
Which of the following would force you to give up your dog?
*
Move locally
Move out of state
Move overseas
What is the name and location of your veterinarian?
Under what circumstances will you not keep your dog?
*
Divorce / Separation
Allergies
Dog barks a lot
Dog digs a lot
Dog nips at strangers
Dog bites kids
Dog loses control of bladder
Dog develops chronic illness
Big vet bills
Dog just un-trainable
Dog is not the kind of dog I thought it would be
Having a baby
Other...
Under what other circumstance will you not keep your dog?
Please describe your animal history below. List the animal, length of ownership, and if you still have the animal. If you no longer have the animal, what happened, i.e., died, lost, stolen, sold, etc. (Click the + icon to add more rows)
Breed
Male/female?
Sterilized
How long owned
What happened.
Click the + icon to add more rows
How did you find our adoption program?
*
Petfinder.com
Facebook
Web site
Referral
Is there anything else you would like us to know?
Email
This field is for validation purposes and should be left unchanged.
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