Adoption Application

	General Applicant Information and Application
First Name:	* required
Last Name:	* required
Street:	* required
City:	* required
State:	CT MA ME NH RI VT
Zip:	* required
Home Phone:	* required
Business Phone:
Cell Phone:
Email:	* required
How did you hear about us?	CRR website Petfinder Flyer in store Newspaper Ad Other, please explain.
	Please answer the following questions to help us find the right dog for your lifestyle and environment.
Name of dog you are interested in:	* required
Why do you want to add a dog to your family?
Please describe the perfect dog for you. What characteristics are most important?
Please describe the activity level of your family. (Active, in and out; traveler, quiet few visitors).
What personality best fits your family's needs and lifestyle?
Would you prefer a male or female?	Male Female No Preference
What size dog would you prefer?
Please list the adults and their ages that live in your home:
Are there children living in your home or visiting on a regular basis?   If yes, please list their ages.	Yes No
	Please verify that your or your landlord's insurance company does not discriminate against certain breeds.   Some companies will not insure homes with what they consider dangerous breeds.
Do you own your home or rent?	Rent Own
If you rent, do you have permission from your landlord to have a dog?	Yes No
Landlord's Name:
Landlord's Address:
Landlord's Phone Number:
	Your dog experience.
What kind of dogs have you owned in the past?
Do you have other pets at home? If so, what are they? (type, age, gender, breed)
If you already own a dog, how will he or she respond to a new dog?
Have you ever introduced a new dog into your household?	yes no
How did you go about doing this?
Have you ever given a dog up for adoption?	yes no
If yes, why? And how did you re-home the dog?
If you owned a dog in the past what did you like BEST about dog ownership?
What did you like LEAST about dog ownership?
	Caring for your dog.
What is your work schedule, please include travel time.	* required
What is your spouse/significant other's work schedule, please include travel time.	* required
How much company will the dog have during the day and with whom?
Will the dog live inside with your family?	yes no
Do you have a fenced yard?	yes no
If yes, what is the fence made of and how high is it?
How will you exercise your dog?
Do you have experience with crate training?	yes no
Would you be willing to crate your dog?	yes no Note: We strongly recommend crate training, especially for puppies.
How long woud you leave your dog in a crate during the day?
Have you ever taken a dog to training?	yes no Note: We highly recommend training. It helps create a bond between you and your new dog, as well as helps resolve or eliminate other issues.
Would you be willing to take your new dog to training?	yes no
	Your dog's health.
If you curently own a dog, is he/she neutered/spay?	yes no
If your dog is NOT neutered/spay please explain your decision not to have this done.
Is your current pet on heartworm preventative?	yes no
Please provide your current vet's contact information.	Name: Address: Phone:
	If you do not currently have a vet, please do a little research and find a vet in your area that you might want to use.   Should you need assistance, we would be more than happy to help you find a reputable vet.
	Please provide the names, phone numbers and emails of two personal references (not relatives).   If you currently have a veterinarian, we will use your veterinarian as one reference.
Reference one:	Name: Phone: Email:
Reference two:	Name: Phone: Email: