Home Adopt a Dog Adoption Application
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* - Denotes required field

Tell us about yourself
First Name:* Last Name:*
Address:* Address 2:
City:* State:*
Zip Code:* Email:
Phone 1:* Phone 2:
Occupation: Hours:
Spouse/Partner Occupation: Hours:
Referred By:


Veterinarian Info
Veterinarian Name: Veterinarian Number:
Veterinarian Address:


Tell us about your home
Type of Home Dweling:*
Fenced Yard: Yes No Type of Fence:
Fence Height: ft.
Is the fenced area attached to the house? Yes No
Does the fenced area have a door leading into the house? Yes No
Any other comments about your environment:
If you have ever owned a dog(s) in the past, please describe what kind:
What happened to your last pet?
How long did you have this pet?
If you have other animals, list type, age & sex:
Have you ever lost a dog? Yes No
Have you ever had a dog killed or injured? Yes No
Do you have any children under the age of 10 in your household? Yes No
If none currently, do you plan on having children in your home? Yes No
List any allergies of home occupants:
Where will the dog be kept during the day?
Where will the dog be kept during the night?
Approximately how many hours will the dog be left alone daily?
Is someone home during the day? Yes No


Adoption Preferences
Do you have a gender preference?
What age of dog are you interested in? Check all that apply:
Puppy (less than 1) Young (1-3) Middle Age (4 - 6) Senior (6+)
Would you be willing to adopt a deaf dog? Yes No
Would you be willing to adopt an OES mix? Yes No
Would you be willing to take your OES to an obedience class? Yes No
Tell us why you want an Old English Sheepdog:*
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