Canine Adoption Application
Please fill out this form completely if you are interested in adopting a dog/puppy from the Kalamazoo Animal Rescue. If your browser has problems with this form, send email and be sure to provide contact information.
You should receive a response to your application with in the next few days.
Please be patient with us. We are all volunteers who donate our time.
Please note that you will need to travel to the foster home(s) in the southwest Michigan area to meet the animal(s) you are interested in. You must be 18 years or older to complete this application.
Please list the name(s) of the dog or puppy that you are interested in and please include the name of the foster volunteer(s).
Your Full Name:
Address
City
State
Zip
Age
Home Phone
Work Phone
Cell Phone
What is the best time to contact you by phone?
Email Address (please enter carefully as we cannot respond to mistyped email addresses)
Your Occupation:
Spouse/Partner/Roommate's Occupation:
If student, where do you attend?
Do you live in a: House Apartment Condo Mobile Home
Do you own or rent? Own Rent
If you rent, please supply landlord's phone number and name of apartment complex:
How long have you been at this address?
Do you have a fenced-in yard (i.e. chain link, electric, kennel area, privacy, other)?
What Veterinarian/Clinic do you use? Please include veterinarian/clinic name along with city and/or phone number.
Do we have your permission to talk with your vet if we need to? Yes No
What kind of heart worm prevention, if any, do you use?
Do you use flea prevention? Yes No
Are your dogs current with vaccines? Yes No
Are your dogs licensed and micro-chipped? Licensed Micro-chipped Both
What best describes the primary pet caregiver? (check all that apply) Retired Stay at home parent Employed part time Employed full time College student Child/Adolescent
How many people are in the household? Please list the names and ages of all adults and children.
Do you or anyone in your household suffer from pet allergies? Yes No
If yes, please explain:
Is the entire family in agreement with adopting a new friend? If not, please explain why?
What is the activity level in your household?
What is your motivation for getting a pet at this time?
Companionship for family or other dog Love animals and want to help a dog in need To teach my children responsibility Guard dog or protection Exercise buddy Just lost a pet Gift for someone (if so, who is the gift for?) Other (explain)
What other pets do you have? Please describe, listing the ages and whether or not they are spayed/neutered.
Have you just lost a pet? If so please explain.
If you have surrendered a pet to an animal shelter or rescue, please tell us why.
If you travel, who looks after your pets when you are gone?
How did you hear about the Kalamazoo Animal Rescue?
Have you ever applied for a dog or contacted the Kalamazoo Animal Rescue before? Yes No
Would you like to receive the our email newsletter? Yes No
Are you a first time dog owner? Yes No
Do you want a puppy, adult, or senior dog? Puppy Adult Senior
Approximate age range you are interested in adopting.
Do you want to adopt a: Male Female Does not matter
What activity level are you looking for in your new dog? (active, mellow, playful) Active Mellow Playful
Are you interested in adopting a specific breed and if yes do you have knowledge of that breed?
Would you still be able to care for this dog if your home or family situation changed (divorce, relocation)? Yes No
Are you prepared for a 10-15 year commitment to a dog? Yes No
If your dog/puppy starts exhibiting behavior problems (excessive barking, chewing, digging, other) what would you do?
Would you be willing to participate in dog obedience lessons? Yes No Maybe
How will your dog be exercised?
How many hours will the dog/puppy be left alone during the day?
Where will the dog be housed? Inside Outside Both
Will the dog be restricted to a certain area? If yes, please describe the area.
Do you crate train and if so for how long?
Where will your dog sleep at night?
Do you collar and tag your pets? Yes No
Any Additional Comments:
