TAILS

Thank you for you interest in adopting from TAILS. This application and an interview with an adoption counselor are designed to help you find a dog that is the most compatible with your lifestyle. The following information is required before we can process your application. You must:

Be 21 years of age or older
Have a photo ID showing your present address
Have written consent or a copy of your lease from your landlord
Be able to spend the time and money necessary to provide training, medical treatment and proper care for a dog.

Completion of this application does not guarantee adoption of a TAILS dog.

Thank You!

Please answer in full the questions below.

First Name:	Last Name:
Street Address:
City:	State:	Zip:
Home Phone:	Work Phone:	Email:
Age:	Place of Employment:
Spouse/Partner Information
First Name:	Last Name:	Phone:

Describe in detail the dog you are looking for:

If you are interested in adopting a specific pet TAILS is currently fostering, please indicate your selection(s): Second choice:

1. For whom are you adopting a dog?
2. Who will be the primary caregiver of the dog?
3. Who will be financially responsible for the dog?
4. Will this be your first dog?	Yes No
5. Are all members of your household in agreement about adopting a dog?	Yes No
6. Why do you want this dog?
7. Is anyone in your household nervous or uncomfortable around dogs?	Yes No

8. Please complete for each adult in your household:

Name: Age: Allergic to dogs? Home during day?

9. Please complete for each child in your household:

Name: Age: Allergic to dogs? Home during day?

10. If children visit your household, what is the age range?
11. How many hours each day will the dog be without human companionship?		Explain:

1. Please select your type of residence:	House Condo Apartment Mobile Home Dormitory Other
2. Do you own or rent your home?	Own Rent
3. If you rent, do you have written consent or a copy of your lease allowing a dog to live in your home?	Yes No
Landlord or condo association:	Name: Phone:
4. How long have you lived at this address?
5. Check if your yard is fenced in:	Please describe:
6. Check if the dog will be tied up at all:	When?
7. Check if the dog will spend any time in the garage:	Explain:
8. Where will the dog be kept during the day?
9. Where will the dog be kept at night?

1. Check if we may call your veterinarian to verify vaccinations, spay/neuter status, and medical history:

Veterinary Practice

Name: City: Phone:

2. Please complete for your current pets:

Species/Breed: Age: Male Female Spayed/Neutered All Vaccinations Current

3. What kinds of pets have you had in the past?
4. What happened to the pets you no longer have?
5. Check if you've ever relinquished your pet to a shelter:	If you checked the box, please explain:
6. Check if you've ever had a pet euthanized:	If you checked the box, please explain:
7. If you have a dog, check if he/she gets along with other dogs:	If you have a dog and didn't check the box, please explain:
8. Was your last or current dog obedience trained?	Yes No
9. If you have a cat, check if he/she gets along with dogs:	If you have a cat and didn't check the box, please explain:
10. Is your cat declawed?	Yes No
11. Check if you are experiencing any difficulties with your current pet(s) in terms of health or behaviour:	If you checked the box, please explain:
12. Have all the members of your household been around dogs?	Yes No
13. Check if you have ever had a pet for a short period of time that didn't work out:	If you checked the box, please explain:
14. Check if you have ever had an animal die as a result of being hit by a car, being poisoned, or from an unknown cause:	If you checked the box, please explain:
15. Have you had a pet that gave birth under your care?	Yes No

1. How much are you willing to spend on medical bills for your dog?
2. What would you do if the vet bills exceed this amount?
3. What provisions will you make for the dog should you become unable to care for it?
4. Do you have any plans to move in the next few years?	Yes No
5. How many times have you moved in the past 5 years?	None Once Twice Three or more
6. What would you do if you moved to a residence where dogs are not permitted?
7. If you go away for a few days/weeks, who will care for the dog?
8. If your new dog/puppy is not housebroken, what method will you use to train it?
9. Would you be able and willing to exercise the dog on a regular basis?	Yes No
10. What will be your methods of exercise?
11. Are you willing to allow a TAILS representative come to your home for a follow-up visit?	Yes No
12. Are you willing to take responsibility for this dog for his/her lifetime?	Yes No

Check if you have ever applied to adopt an animal from TAILS in the past:	If so, when:
Is there anything else you would like us to know?
Please provide three personal references not related to you	Name: Phone: Name: Phone: Name: Phone:

By clicking the submit button below, I certify that:

The information I have provided is true and accurate
I understand that TAILS has the right to deny any application
I give permission for a TAILS representative to contact the references and veterinary practice I have listed

Please print a copy for your records before submitting.