ADOPTION APPLICATION

Contact Information

First Name

Last Name

Co-Applicant's Full Name

Phone

Birthday

Month

Day

Year

Address - Line 2

City

State

Zip

Do you rent or own?

Rent

Own

What type of home do you live in?

Do you have a fenced yard?

Yes

If you do not have a fenced yard, how do you plan to exercise your pet?

Have you ever owned a Japanese Chin?

Yes

Would you consider a Chin with special needs?

What other kinds of pets do you own?

How long are your pets left alone each day?

If you currently have dogs/cats, are they spayed/neutered?

Where will your dog stay when you're not at home?

What are your expectations about owning a dog?

What makes you a good pet owner?

Under what circumstances would you give up your dog?

Is there anything else you'd like to share with us?

Please list three references including their names and phone numbers. No family members, please.

Reference #1

Reference #2

Reference #3

Please list your vet's name and phone number.