Name of dog applying for: Sex: Male Female
Applicants Name:
Street Address:
City State Zip
Phone (Home) (Work)
Email Address
Are you 18 yrs or older? Yes No
Do you Own Rent
If you rent, name and phone number of Landlord:
Who are you adopting this dog for?
How do you plan to keep the dog confined to your property? In the house Fenced Yard Kennel or crate Tie-out chain Garage Outside dog run Other
Where do you plan to keep the dog during the Day? Night?
Number of children in your home? Ages?
Have you owned a dog before? Yes No
List your prior pets (last 10 yrs) and why they are no longer with you:
Do you currently own any pets? Dog, Cat, Other
Are current pets spayed/nuetered? Yes No If no, please explain:
Name of Vet
Training methods you plan to use?
Are you willing to allow some time for adjustments? Yes No
From where did you hear of us?
By submitting this application, I certify that the information provided on this application is true and correct. I am also financially and physically able to care for this animal. I understand that proper food and veterinary care can be costly and I am able to meet these requirements.
If upon inspection RottsnMore finds that information contained in this application to be false, RottsnMore retains the right to turn down or remove the animal from your premises.
