Dog Adoption Questionnaire

Dog Adoption Questionnaire
The Name of the dog I am interested in is:
Have you read, understood and agree to our adoption guidelines at this link on our page : https://www.facebook.com/ARCATDistrict/posts/2163371267088653?__tn__=-R-R*

YesNoI'd like more information
Tell us about yourself:
Name*

First NameLast Name
What is your age range:*

18-2526-3536-4546-5556-6565+
Address*

Street Address

Post box if different

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Mobile Number
Email
example@example.com
What is your work schedule:*
If you have a partner, what is their work schedule:
Please list everyone the pet will live with, their relationship to you and their ages:*
Does anyone have animal-related allergies and if yes, please give details:*
Are you a permanent resident:*

YesNo
Tell us about your Home
Do you own or rent your home :*

OwnRent
If you rent, how long is your lease:*
If you rent, do you have permission to keep dogs and if yes, how many*

YesNo123
Is your residence :*

A houseAn apartmentA townhouseA house on acreageOther
As all Council's require adequate fencing for dogs, please descibe the fencing you have to secure your dog :*
If your property has a pool, is it dog proof and, if not, how will you manage this potential danger :*
Tell us about your Pets
If you already have a dog or dogs, please list them here and include their breed (if known) ages, gender and if they are neutered or entire.*
If you've had experience training a dog, please describe your experience :*
Do you have any other pets and if yes, how many of each :*
About your adoption
Tell us why you want to adopt a dog :*
Where will your adopted dog sleep :*

Inside the houseOutside the house
If outside the house, please describe where :*
Which areas of your home would be off limits to the adopted dog :*
Where will the adopted dog be left when home alone :*

IndoorsOutdoorsAccess to both
How many hours will the adopted dog be left home alone each week :*
Can we know the name of your veterinarian/clinic:*
May we contact your vet for a reference :

YesNo
If yes, please provide the phone number :
Do you have any concerns about adopting :*
Is your family supportive and looking forward to adopting :
All of the information I have provided is true and correct. If any information changes, I will advise ARCAT promptly.
Signatue/s:
Date

MonthDayYear
Date
Enter the message as it's shown*
Thank you !!! We appreciate your time and effort and we'll be in touch just as soon as we can !!!
Should be Empty:

Dog Adoption Questionnaire

Tell us about yourself:

Tell us about your Home

Tell us about your Pets

About your adoption