SBRET Adoption Application
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How did you hear about us? *
Name *
Home street address *
Apartment of unit number
City or town *
State *
Zip code *
How long have you been at your home address? *
Mobile phone *
Work phone
Email address *
Age *
Occupation *
Do you own or rent? *
If renting, please provide landlord's name and phone number (NA if not renting) *
Do you have permission from your landlord to have a dog? *
Are you interested in a particular dog? *
If yes, which one?
What are your reasons for wanting to adopt a dog at this time? *
Please share with us any special activities you will do with your new pet.
Do you have any children, expecting or planning to have children, or have children visiting your home? *
If there are children in the home or who will be visiting, please give their ages (NA if no children) *
Who is the dog primarily for? *
Who will have chief responsibility for the care of your new pet? *
Does anyone in your household have allergies? *
Please list individualy all pets you currently own and have previously owned within the last 15 years.
Pet 1 Name
Pet 1 Age
Pet 1 Still living with you
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Pet 2 Name
Pet 2 Age
Pet 2 Still living with you?
Clear selection
Pet 3 Name
Pet 3 Age
Pet 3 Still living with you?
Clear selection
Pet 4 Name
Pet 4 Age
Pet 4 Still living with you?
Clear selection
Pet 5 Name
Pet 5 Age
Pet 5 Still living with you?
Clear selection
If the pets listed above are no longer with you, please explain (NA if never had pets): *
Where do your current pets (or previous pets) stay during the day (NA if never had pets)? *
Where do your current pets (or previous pets) stay at night (NA if never had pets)? *
Are your current pets or were your previous pets spayed/neutered?
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Are your current pets or were your previous pets current on vaccines?
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Are your current pets or were your previous pets current on heartworm prevention?
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Have you ever had a pet run away? *
If yes, please explain (NA if never had pets run away). *
Where will your new dog be during the day? *
Where will your new dog be at night? *
How many hours a day will your new pet be alone? *
Is your yard fenced in? *
If you have fence, please provide type and height (NA if no fence): *
If do not have a fence, how will you monitor your dog when outside your house (NA if you have a fence)? *
Do you have a swimming pool? *
If yes, do pets have free access to the pool? *
Where will the dog stay when you are on vacation or out of town? *
What behaviors, if any, would cause you to give up your dog? *
If you move, will your dog move with you? *
Please provide the full name of your current or previous veterinarian. *
Please provide the address of your veterinarian. *
Please provide the phone number of your veterinarian. *
May we contact your veterinarian for a reference? *
Please provide the full name account is under. *
Please provide the full name and phone number of a personal reference. *
If you adopt a rescue dog and decide to give it up, do you agree to contact us and make arrangements to get the dog back to SBRET? *
Have you or members of your household been cited for leash law violations or cruelty to animals? *
If yes, please explain (NA if no violations): *
Have you applied to other rescue groups? *
If yes, please provide the name of the rescue group (NA if no applications to other rescue groups). *
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