Adoption Application – Karma K-9 Rescue

Applicant #1 Name*

First Last

Age*

Occupation*

Applicant #2 Name

First Last

Age

Occupation

Address*

Street Address Address Line 2 City State Zip

Phone*

Email*

Are there children in the home?*

No
Yes

What are the children's ages?*

Have the children been around dogs?*

No
Yes

Rent or Own*

Rent
Own

Time at current residence*

Does your home have a fenced yard?*

No
Yes
Partially fenced

Where would the dog stay during the day?*

Where would the dog spend the night?*

Where would the dog go while you were on vacation?*

Is there a particular dog you're interested in?

Why are you choosing to adopt?*

Do you have a trainer?

What activities will you be doing with the dog?*

Will the dog be used as a guard dog?*

What animals do you currently own? (species, name and age)

What animals have you previously owned?

Why would you give up a dog?*

Are your pets neutered?*

No
Yes
N/A

Are your pets up to date on vaccinations?*

No
Yes
N/A

Are your pets on heartworm preventative?*

No
Yes
N/A

Vet name

Vet Number

Personal Reference #1*

First Last

Phone*

Personal Reference #2*

First Last

Phone*

If you would like to add any additional information, please do so here

Hidden

Date*