Dog Adoption Application Please answer every question in order for your application to be considered. Completing an application is not a guarantee of adoption. Dog's Name Your Name Your Age Address Address Address 2 City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP Code Preferred Phone Number Alternate Phone Number Email Are you the home owner or primary lease holder? If no, we can’t accept application unless head of household is present. - Select -YesNo Have you had a dog before? - Select -YesNo Have you had any pets in the last 5 Years? - Select -YesNo Complete the information about ALL of the pets you have had in the past 5 years, including current pets Type/Breed Age Sex - None -Female (Spay)Female (Not Spayed)Male (Neutered)Male (Not Neutered) Licensed - None -YesNo Where is the pet now? Do you have a second pet? - None -YesNo Type/Breed Age Sex - None -Female (Spay)Female (Not Spayed)Male (Neutered)Male (Not Neutered) Licensed - None -YesNo Where is the pet now? Do you have a third Pet? - None -YesNo Type/Breed Age Sex - None -Female (Spay)Female (Not Spayed)Male (Neutered)Male (Not Neutered) Licensed - None -YesNo Where is the pet now? Do you have a fourth pet? - None -YesNo Type/Breed Age Sex - None -Female (Spay)Female (Not Spayed)Male (Neutered)Male (Not Neutered) Licensed - None -YesNo Where is the pet now? Do you have a fifth pet? - None -YesNo Type/Breed Age Sex - None -Female (Spay)Female (Not Spayed)Male (Neutered)Male (Not Neutered) Licensed - None -YesNo Where is the pet now? What is the reason for wanting to adopt this dog? (Check all that apply) Personal/family companion Companion for other pet For children Gift Guard Dog What characteristics are you looking for in a dog? (Check all that apply) Active Affectionate Mellow Quiet Playful Independent Outgoing/Sociable Lap Dog Good with other dogs Good with other animals Good with children Do you live in a: - Select -HouseTownhome/CondoApartmentDuplexMobile home Do you: - Select -OwnRent Landlord Name/Number Note: Staff will contact landlord Are you prepared to pay any required pet deposits or pet rent? - Select -YesNo If you move (locally, out of state, or out of the country) what will you do with this dog? Do you have a fenced: Yard Patio Balcony None What type of fencing is it? What is the fence height at the lowest point? Do you have a pool? - None -NoYes Is the pool gated? - None -NoYes How many adults are in your household? - Select -12345678+ What are their ages? How many children? - Select -012345678+ What are your children's ages? Has every member of your household agreed to adopt this dog? If this has not been discussed at great length, please complete application when that has occurred. Does any member of your household have pet allergies or asthma? Does any member of your household have pet allergies or asthma? - Select -NoYes, please describe: Enter other… What is the activity level in your household (including yourself)? - Select -Mellow (quiet)ModerateActive (loud, busy) Is someone home during the day? - Select -NoYes Who is home? How many hours will this dog be alone each day? Where will this dog be kept when it is left alone? Where will this dog be kept when you are at home? Where will this dog sleep at night? Who will care for this dog when you are on vacation or out-of-town? The annual cost associated with providing responsible care (vaccinations, medical care, boarding, supplies, etc.) to a healthy dog is approximately $1500. Do these costs present any financial problems for you? - Select -NoYes Are you willing to potty train this dog if needed? - Select -NoYes Are you willing to take this dog to training classes if needed? - Select -NoYes If yes, do you know where? Are you prepared to make a commitment of 10 to 18 years to this dog? - Select -NoYes Which may prompt you to relinquish, return, or rehome your dog? (check all that apply) None Illness of yourself Illness of dog Marking in the house Moving Allergy to dogs Dog develops allergy Potty accidents/unable to potty train Too active Fence jumping Digging Chewing/destructive behavior Shedding Hiding for a week Growling Non-compatible with other pets Barking Biting Other (explain) Enter other… Have you ever had to give up a pet? Have you ever had to give up a pet? - Select -NoYes, explain when and why? Enter other… If your dog gets sick, what will you do? Do you have a current veterinarian? Do you have a current veterinarian? - Select -NoYes, list name and phone number: Enter other… Have you adopted any animals from Mission Viejo Animal Services before? Have you adopted any animals from Mission Viejo Animal Services before? - Select -NoYes, do you still have this/those animal(s)? Enter other… Have you completed an application to adopt an animal from our shelter in the past 12 months? Have you completed an application to adopt an animal from our shelter in the past 12 months? - Select -NoYes, which animal (name)? Enter other… Your application will be reviewed along with all others received by Animal Services personnel to ensure that the best home possible is selected for this animal. Animals are NOT adopted solely on a first come– first served basis. Incomplete applications forms are grounds for denial of adoption. We Reserve the Right to Refuse the Adoption of any Animal. I hereby certify that the above answers are true, to the best of my knowledge, and I understand that if approved, I must sign and abide by an Adoption Agreement. Your Signature Sign above Leave this field blank
