Dog Adoption Application

WE ONLY ADOPT TO KENTUCKY, INDIANA, AND OHIO

Any information found to be incorrect may result in this application being denied.
We accept cash or check only for adoption fees.
Thank you for adopting a pet in need.

If your application is approved we will notify you by email on a date and time to come meet the pet.

Note: This form is most successful when completed from a desktop or laptop computer. Form submission may fail if you complete from a mobile device.

You will receive an email confirmation that your form has been completed successfully.

Which dog are you interested in?*

We know them by NAME not by a number
Dog Breed (select "Other" if interested in multiple dogs)*
Your Name*
First Last
Address*
City*
State of Residence*
County of Residence*
County of Residence*
County of Residence*
Zipcode*
Primary Phone Number*
Secondary Phone Number (if applicable)
Alt Phone (if applicable)
Email*
Enter Email Confirm Email
What is your age?*
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What is your age (not used)
Please enter a number greater than or equal to 0.
Date of Birth*
Do you live in a:*
- House
- Apartment
- Townhouse
- Condo
Do you rent, lease or own your home? (If your name is not listed as the owner of the property, select Rent or Lease. We will verify your residency.)*
- Rent
- Lease
- Own
Landlord/Property Owner Name (We will seek landlord approval to place a SAAP pet in your home.)

If you are not the property owner we will need your landlord information.
Landlord Phone
Are there any other adults living at your address? If so, please list their names.
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Do you have an HOA?
- Yes
- No
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HOA name:
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HOA phone:
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Have you ever given up an animal?*
- Yes
- No
If yes, why and where did you take it?
Have you ever been issued a citation for your pet or had to reclaim your pet from the animal control/shelter?*
- Yes
- No
If yes, please explain
Are there children in your home?*
- Yes
- No
What are their ages?
List any previous and current pets. Pet 1 Name:*
Pet 1 Type (Dog, Cat, etc.):
Pet 1 Gender:
- Female
- Male
Pet 1 Health Conditions or Cause of Death:
Was Pet 1 spayed/neutered?
- Yes
- No
If yes, where:
Is Pet 1 up to date on vaccinations?
- Yes
- No
Do you have a second current/previous pet to add?
- Yes
- No
Pet 2 Name:
Pet 2 Type:
Pet 2 Gender:
- Female
- Male
Pet 2 Health Conditions or Cause of Death:
Was Pet 2 spayed/neutered?
- Yes
- No
Pet 2 spay/neuter: If yes, where?
Is Pet 2 up to date on vaccinations?
- Yes
- No
Do you have a third current/previous pet to add?
- Yes
- No
Pet 3 Name:
Pet 3 Type:
Pet 3 Gender:
- Female
- Male
Pet 3 Health conditions/cause of death:
Is Pet 3 spayed/neutered?
- Yes
- No
Pet 3 Spay/Neuter: If yes, where?
Is Pet 3 up to date on vaccinations?
- Yes
- No
Do you have a fourth current/previous pet to add?
- Yes
- No
Pet 4 Name:
Pet 4 Type:
Pet 4 Gender:
- Female
- Male
Pet 4 Health conditions/cause of death:
Is Pet 4 spayed/neutered?
- Yes
- No
Pet 4 spay/neuter: If yes, where?
Is Pet 4 up to date on vaccinations?
- Yes
- No
Do you have any additional pets to add?
- Yes
- No
Please list any additional pets' names, types, gender, health conditions, whether they are spayed/neutered, and if they are up to date on vaccinations.
When you are NOT HOME, where will your pet stay?*
- Indoors with access to go outside
- Indoors with free roam of house
- Indoors in a crate
- Outside with access to indoor area/shelter
- Strictly Outdoors
- Other
Please explain your answer with as much information as possible.
Where will the pet stay during the day?*
Where will the pet stay during the night?*
Will your pet be crated?*
- No
- Yes
If you answered YES to crating your pet, please give a description on how and when the dog will be crated. If you answered NO to crating your pet, where do you plan to keep your pet while away from the home, especially while potty training?*
Does your home have a pet/dog door?*
- Yes
- No
If yes, will the pet have access to the pet/dog door when you are not home?
- Yes
- No
Please describe when your pet would have access to the pet door and how monitor their time outside*
How many hours per day will the pet be left alone?*
Do you have a fenced yard?*
- Yes
- No
If YES, what type and size? If NO, how do you plan to keep the dog in your yard?*
How many stairs do you have to get to your yard?*
Please describe the method you plan to use to housebreak the dog. (frequent trips outside, pads, bell, etc)*
If you have to move, what would you do with your adopted pet?*
What circumstance would you have to surrender your pet? Divorce? New baby? allergies? aggression? housebreaking issues?*
Are you ready for a possible 20 year commitment?*
- Yes
- No
Have you ever taken a dog through obedience class? Do you plan to take this one?*
Can you financially afford the Veterinarian costs for your new pet? Emergency Costs?*
- Yes
- No
Your current Vet and phone number:*
What energy level are you looking for in a pet?*
- High
- Medium
- Low
Please list the activities you plan on doing with your dog.*
Please list at least 2 references: Please include first and last name and phone number.*
Other Information or comments:
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