Please Note: All fields are required before submission of this form. Thank You.

    Before you complete this application, please confirm that you are:

    • Parent or Head of Household
    • Age 21 or Older
    • Ready to adopt a dog NOW (we don't "hold" applications for future adoptions)
    • We do not "ship" our pets out of California or the country

    This Application must be completed by Adult Head of Household/Parent(s) only.
    Please complete all questions and fields. If not applicable, please indicate.

    Date

    Name of dog you are interested in:



    About You


    Your Name

    Email Address

    Address

    City

    State

    Zip

    Home Phone

    Work Phone

    Cell Phone

    Have you adopted from us before?

    If yes, who and when?

    Have you ever owned a dog before?

    If yes, what happened to it?

    What kind of dog are you looking for?

    What are your reasons for adopting a dog?

    Who is the dog for?

    Who will be primarily responsible for the dog's care?

    Is it a gift?

    How many people are living in your household including yourself?

    What are their ages?

    If anyone under age 18 is living with you, have they been around dogs before?

    Does anyone in the household have allergies?

    If Yes, please explain:

    What circumstances would cause you to return the dog to New Beginnings for Animals?

    Dog Experience:

    What best describes your lifestyle:

    Do you work outside the home?

    If yes, how many hours a day are you out of the house?

    Does anyone in your household smoke?

    If your adopted dog develops behavior problems, how will you handle it?

    Have you ever had to give up or rehome a pet?

    If Yes, please explain:

    Do you currently have pets?

    If Yes, please specify breed, age, and sex:

    Are they spayed / neutered?

    If No, What is the reason:

    Are they currently licensed?

    Are they current on vaccinations?

    Can you provide proof of vaccinations?

    Are you aware of the dangers of coyotes and other wildlife in this area?



    Home Information


    Type of dwelling

    Rent or Own

    If you Rent, do you have Landlord's permission?

    Please provide landlord’s name and phone number:

    (Your landlord will be contacted for verification as part of the adoption application approval process)

    Years at this residence:

    Do you have a yard?

    Do your gates have locks?

    If Yes, is it fenced?

    If Yes, how high is the fence and what type?

    Do you have a patio?

    If Yes, is it fenced?

    If Yes, how high is the fence and what type?

    Do you have a balcony?

    If Yes, is it fenced?

    If Yes, how high is the fence and what type?

    Do you have a jacuzzi/spa or pool?

    If Yes, is it fenced?

    Where will your dog spend time while you're home?

    Please explain:

    Where will your dog be kept when no one is home?

    Please explain:

    How many hours will your dog be alone each day?

    What type of outdoor shelter is currently available?

    Where will the dog sleep at night?

    Who cares for your dog when you vacation?

    Are you aware that you will be paying a non-refundable adoption fee for this dog?

    Having a pet can cost you over $1,000 in the first year, and well over $500 each additional year. It's estimated that the annual cost for basic care (food, supplies, grooming, flea treatment) was on average $1,270, not including medical treatment for emergency health issues. Are you able and willing to pay these basic expenses PLUS any additional costs if your dog becomes sick or injured?

    Please explain:

    What veterinarian(s) treated your previous and current pets (dogs and cats)? Please provide the following information (Your vet will be contacted for a reference as part of the application approval process):

    Vet's Name:

    Vet's Phone:

    Vet's City:

    Do you object to New Beginnings doing a home check prior to adoption of the dog or following placement in its new home?

    How did you hear about New Beginnings for Animals?

    DISCLAIMER:

    All of the information I have provided on this application is true and correct. I understand that New Beginnings for Animals has the sole discretion, with or without cause, to accept or decline this application. I understand that completing this application does not guarantee that I will be approved to adopt the dog I applied for. I understand that if there is more than one application for a dog, it is the policy of New Beginnings for Animals to match the applicant that is the best fit for the dog.

    Signature of applicant (Please type name)

    Date: