Dog Adoption Application

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Default: Adopter Status
First Name*
Last Name*
Age Range*
eMail Address*
We only adopt locally. Do you live in or near Colorado?*
- Yes
- No
Street Address*
Suite | Apt or Unit Number
City*
State/Province*
ZIP*
Phone Number*
- Preferred Method of Contact*

Below are three areas for information on other members of your family. Please include all other adults, children and pets living in your home by clicking on the designated button.
Are There Other Adults In The Home?*
- Yes
- No

Add Adults

First Name	Last Name	Age Range	Actions

There are no Adults.

Are There Children In The Home?*
- Yes
- No

Add Children

Name	Age	Actions

There are no Children.

Do you have now, or have you ever had, a dog?*
- Yes
- No
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Have you ever taken care of a dog before (ie dog walker, dog sitter, etc) or have any other dog experience?*
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Why Not?*
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How Long Did you Have the Dog*
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Additional Information

Add Dogs

Dog's Name	Age Range	How Long Did You Own Him/Her?	Actions

There are no Dogs.

Are There Other Pets In The Home?*
- Yes
- No

Add Pets

Pet's Name	Animal Type	Actions

There are no Pets.

What Are You Looking For?
- Do you have a specific dog in mind?*
  - Yes
  - No
- Do You Have A Preferred Dog?*
  Note: This does not guarantee this dog will be placed with you
- Tell us what you're looking for (size/age/gender/breed/temperament, etc.)*
- Would You Consider Fostering While Waiting For The Perfect Dog?*
List Other Dogs You Are Interested In
When Will You Be Ready To Adopt?*
Is There Anything Else You Would Like to Let Us Know?
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A Dog That is Not Completely Housebroken?*
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Select Gender*
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Select Age Range*
Select All That Apply
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Select Personality*
Select All That Apply
I am interested in receiving pet related services and products*
- Yes
- No
Authorization
Authorization:*
All dogs placed through the Scroungy Dogs and Pretty Pups Rescue will have health checks, personality and temperament evaluations, and will be spayed or neutered prior to placement unless a medical condition exists, diagnosed by a veterinarian, that would prevent this surgery. I understand that this is a preliminary application and that there may be no Dog available in rescue at this time. I further understand that all information on my Preliminary Rescue Adoption Application will be kept confidential; that my application will be kept on file until I notify the Scroungy Dogs and Pretty Pups Rescue that I am no longer interested in a rescue; and that I will not be contacted unless an appropriate Dog becomes available.

Scroungy Dogs and Pretty Pups Rescue has no way of knowing the actual breeds or ages of any of our dogs. The breeds and ages listed are entirely speculation and guesses based on looks. Scroungy Dogs and Pretty Pups Rescue does not guarantee that any dog is actually the breed or a mix of the listed breeds. They are almost all mixed breed dogs, probably mixed with many breeds.

I understand and agree *
- I agree
Name
This field is for validation purposes and should be left unchanged.

Adoption

Residence

Yard Information

Family & History

Feeding & Exercise

Sleep & Alone Time

Behavior & Training

What Behaviors Can You Tolerate (and work on)?

Personal Reference 1

Personal Reference 2

Veterinarian Information

What Are You Looking For?

Authorization

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