Dog Adoption Form

For us to process your adoption, please fill out the following form. We will try to get back to you within 1-2 business days. If you haven’t heard from us in a few days, we’re still processing your application. We haven’t forgotten about you! If you have any questions, comments, or concerns, please feel free to contact us anytime!

Before you apply please be sure that EVERYONE in the household is in agreement with adopting this dog.

Your Information

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Dog Information

Tell us a bit about the type of dog you're looking for.

Which dog or dogs are you interested in?

List the names of our available pups you're interested in

How active do you want your dog to be?

Where will your dog be kept when you are not at home?

How many hours per day would your dog be alone in the house?

Do you plan to enroll in obedience training?

Yes

If you have ever surrendered a dog to a shelter or someone else, please explain why

If this doesn't apply, you can leave this question blank.

Building information

We will need to know what type of environment you live in so we can better connect you with the right dog!

What type of building do you live in?

If you are renting, please provide your landlords name, email address, and phone number

Please check with your landlord to ensure dogs are allowed. If you are not renting you can leave this question blank.

Do you have a fenced in yard, or electric fence?

We do not require you to have a fenced in yard this just helps us place you with the perfect dog.

Yes

Please list everyone in the home

List each person on a new line in the format: Name, age

Please list all the pets currently living in your home

List each pet on a new line in the format species (dog, cat, etc), name, age. If you don't have any pets leave this question blank.

Please list all past pets you've had in the last three years

List each pet on a new line in the format species (dog, cat, etc), name, age. If you don't have any past pets leave this question blank.

Would you agree to a home visit?

Yes

Occupation

Please list your occupation and how long you have worked there. If you have a spouse/partner please list their occupation as well along with their length of employment.

This will help us connect you with the perfect furry friend for your lifestyle!

Vet Information

Please call your veterinarian to give permission to release information to Little Hills Rescue.

Veterinarian Name

Veterinarian Phone Number

(###)

###

####

References

We require at least two references.

Reference One

First Name

Last Name

Phone

(###)

###

####

Reference Two

First Name

Last Name

Phone

(###)

###

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