Dog Adoption Form
All About Animals NJ
Which dog are you interested in adopting?
1st choice:
2nd choice:
Unsure/No Preference
Name: Drivers License:
Address: Rent:  Own: Birthdate (MM/DD/YY)
City:   State:  Zip Code:
Time at Address: email:
Home Phone:  Alternative Phone:
Employer's Name: Employer's Phone:

If you are a renter (Please note that you will be required to prove that pets are OK):

Landlord's Name: Landlord's Phone:

Household Information

Does anyone in your household suffer from allergies? YesNo
Is everyone in your household aware of an agreed upon getting a dog? YesNo
How frequently do you travel for business or pleasure?
What will you do with your dog while traveling?
How many hours a day will the animal be left alone?
How will you discipline the dog?
Is there someone who can take care of the dog permanently if you are no longer able to?
Name : Phone:
Relationship to you:
Residence Type: Home Townhouse Apartment Mobile Home
Activity Level in House: Quiet Active Hectic
Adult Members of Household: Number and Ages of Children:

What you are looking for in a dog

Gender: Male Female No preference Age: Puppy Adult Senior No preference
Coat: Short Medium Long No preference
Activity Level: Low Moderate High No preference
Where will the dog be kept when you are not home? Free Access to the House Outside In a Crate

Characteristics: Check all that apply
Dog Friendly Kid Friendly Cat Friendly Playful Obedient
Lap Dog Quiet/Calm Affectionate Shy Naughty
Rambunctious Lazy Watch Dog Energetic Exercise Partner

Under what conditions would you consider giving up this dog? (Check all that apply)
personal move personal illness stealing food chewing
biting allergies growling pregnancy/new baby
Peeing/Pooing in House compatibility with other pets
Disobedience Too Active Hiding for first 1 or 2 weeks
Other (please explain):
Do you have a yard? YesNoIf yes, is it fenced? Yes NoHeight?
Do you have a porch? YesNo Do you have a pet door? Yes No

Do you realize that a dog can cost over $1000 per year? YesNo
What will you do if the costs exceed that amount?
Are you aware that dogs can live between 10 and 15 years? Yes No
Have you ever adopted an animal before? Yes No
If yes, from where?
Have you ever had to give up/surrender a pet? Yes No
If yes, please provide details:

Will you agree to a home visit? Yes No Will you agree to a follow up visit? Yes No
Why do you want a dog? Kids Companion Gift Other:
If a gift, is the person aware that they will receive a dog? Yes No

Who will feed the dog? Walk the dog?
Who will be responsible for training/disciplining the dog?

Information about other pets

Name Breed Sex Age Spayed/
Declawed? Still with you?
why or why not)
MF YesNo Indoor
MF YesNo Indoor
MF YesNo Indoor
MF YesNo Indoor
MF YesNo Indoor
MF YesNo Indoor

Veterinary Information

Current Veterinarian: Phone:
Do we have permission to contact your vet for a reference? Yes No
Person's name your pets are listed under:
Previous Vet (if with vet < 2 years): Phone:

By clicking submit you agree that you have answered all questions truthfully and understand that any intentionally false statements will cause this application to be void.