Open Door Animal Sanctuary

    Canine Preliminary Adoption Form

    This questionnaire must be filled out by all persons interested in adopting a pet from our shelter. The information you provide will not be given to any other organization. It is our job to find permanent, responsible homes for as many of our animals as possible and at the same time to find the right pet for you. To do this, we need specific information from you. Thank you for visiting the Open Door Animal Sanctuary.

    Adopter's Name*

    Your Email*

    Adopter's Age (Must be 21 to adopt)

    Address

    City

    State

    Zipcode

    Home Phone

    Work Phone

    Cell Phone

    Which dog/puppy are you interested in?

    1. I live in a
    HouseApartmentCondoTownhouseMobile Home

    2. I OwnRentLive on CampusLive with Parent/Relative

    If you live with a parent/relative, are they aware you are here?
    YesNoN/A

    If you are renting your home, what is the name of your landlord? If you are living in a mobile home park, what is the name of it?
    Name
    Phone

    3. How many times have you moved in the last 3 years?

    Did your animals move with you?
    YesNoN/A

    4. Number of children at home

    Children's Ages

    Have they been around animals before?
    YesNoN/A

    5. For what purpose are you adopting an animal?
    CompanionshipAs a GiftHunting DogFor Children/Grandchildren to Play WithGuard Dog

    If you want a pet to give as a gift, who are you giving it to?

    6. Occupation

    Employer

    7. Please list the breeds and ages of all pets in your household

    8. Do they live
    OutsideInside

    How many of these animals are spayed or neutered?

    Are they current on vaccinations?
    YesNoN/A

    Are your dogs currently on heartworm preventative?
    YesNo

    Name and Phone of Your Veterinary Clinic

    9. Have you adopted animals from Open Door Sanctuary?
    YesNo

    If yes, how long ago?

    10. Please list all animals you have owned in the last 5 years

    Where are these animals now?
    Gave AwayLostReturned to AgencyStill HaveDied

    Please explain

    Have you ever taken an animal to a shelter?
    YesNo

    Please explain

    11. How many hours of the day will the new animal be alone?

    Where will the animal be alone at?

    12. Where will this animal sleep?

    Do you plan on crate training?
    YesNo

    13. If you are adopting a dog how do you plan to confine this dog when it goes outside?
    ChainLeashFenced YardKennelAcreageChain & CableElectric FenceRunner

    If your yard is fenced how high is the fence?

    14. Have you ever raised a puppy?
    YesNo

    If yes how long ago?

    15. How was your previous dog/puppy trained?
    TrainerObedience ClassPersonallyN/A

    16. What canine behavior are you UNWILLING to work with?

    17. Is this your first experience owning a dog on your own?
    YesNo

    18. What will happen to this pet if you experience a major life change (such as move, divorce, new baby, or health change)?

    19. Do you understand that adopting an animal is a lifetime commitment and are you willing to accept this responsibility?
    YesNo

    20. Where did you hear about ODAS?

    21. Would you like to join the ODAS mailing list to receive event invites and our quarterly newsletter?
    YesNo

    If yes, what is your preferred contact method?

    Because of our concern for placing the appropriate animal in your home, we ask that you read & agree below:
    *A representative of the ODAS will visit my home prior to adopting to verify all information given on this application.
    *The decision of the ODAS personnel is final.
    *All adoptions must meet the criteria of the ODAS general adoption policies.
    *I have answered all questions of this application truthfully and to the best of my knowledge.

    I agree
    YesNo

    WE RESERVE THE RIGHT TO REFUSE ANYONE FOR ANY REASON!!!