Dec 17, 2017 - Yes â¡ No. 6. Is anyone in your home allergic to dogs? â¡ Yes â¡ No. 7. Where will your dog stay when
Dog Adoption Application Please read carefully before completing the application: We request that potential adopters fill out the questionnaire with as much detail as possible, if a question is not applicable please put N/A. The information gathered in this questionnaire is to help assist Township and Kennel staff in pairing dogs with adopters. Name:_________________________________________________Date:_________________________ Address:________________________________________________________ Unit #:______________ City:__________________________________________________ Postal Code: __________________ Phone #:______________________________ Alternate Phone#:______________________________ E-Mail:______________________________________________________________________________ Dog you are applying for: _______________________________ ABOUT YOU AND YOUR HOME 1. Please select the appropriate age category
□ Under 18
□ 18+
2. What best describes your living environment?
□ House □ Condo □ Townhome □ Apartment □ No yard □ Small Yard □ Large Yard □ Acreage Do you: □ Own □ Rent
11. What sort of enrichment would you plan to offer?
□ Dog Park □ Agility training □ Short Walks □ Runs □ Clicker training □ Long walks □ Other___________________________________ 12. Do you have a veterinarian? □Yes □No Please provide contact information for veterinarian ___________________________________________ ___________________________________________
3. In your house, number of: Adults(18+)_____
Children_____
4. Are there other pets in your household?
□ Yes □ No
5. Are your pets up to date with vaccines?
□ Yes □ No
6. Is anyone in your home allergic to dogs?
□ Yes □ No
7. Where will your dog stay when you are not home?
□Loose in house □ Crated inside □ Outside □Spare Room □Other:____________________
8. Will the dog be primarily kept indoors or outdoors?
□ Indoors □ Outdoors
□Yes □No 10. Were you the primary caregiver? □Yes □No
9. Have you had dogs before?
13. How often should your dog see a veterinarian?
□ Once every three years □ When its sick □ Annually □ Twice per year □ Once a month □ Other___________________________________
14. What is the best diet for your dog?
□ Dry/Kibble □Raw □ Table Scraps □ Homemade □ Wet/Canned □ Vet recommended □ Other___________________________________
15. What do you estimate the annual cost of caring for a dog including food and vet care?
□ $100-$500 □ $1000-$1500
□ $500-$1000 □ $1500+
16. What do you believe is the optimum amount of time spent with your dog daily?
______________________
IT IS VERY IMPORTANT FOR MY DOG TO… (CHECK ALL THAT APPLY)
□ Be friendly with Children
□ Be friendly with house visitors
□ Be playful
□ Be calm
□ Be friendly with other dogs
□ Be friendly with cats
□ Enjoy being held
□ Be quiet
□ Be independent WHICH OF THE FOLLOWING WOULD YOU BE WILLING TO WORK ON WITH YOUR NEW DOG?
□ House Training
□ Separation Anxiety
□ Jumping up and mouthing
□ Food and/or toy possessiveness □ Shy/ Fearful behaviours
□ Aggression
□ Barking problems
□ Basic training/ leash skills
□ Socialization
REFERENCES AND AGREEMENTS 1. I hereby give permission to the Township of Oro-Medonte to contact my veterinarian to verify any and all animals I have had or currently have. 2. I, the undersigned, certify that the information in this form is true and correct. 3. I understand and agree that the care, feeding, training and well-being of an animal is my responsibility. 4. I understand that I may not be able to adopt the pet I have chosen if this animal would not be a good match due to lifestyle or housing/safety concerns. 5. I understand that the Township of Oro-Medonte has the right to refuse adoption to anyone. 6. I understand that only successful candidates will be contacted.
Applicant signature: _____________________________Date: ___________________________
Please complete the application and submit via email to
[email protected] or hand deliver to the Township of Oro-Medonte 148 Line 7 South, Oro-Medonte L0L 2E0 Attn: Curtis Shelswell no later than 11:59 p.m. on December 17, 2017
Personal information contained on this form is collected pursuant to The Municipal Freedom of Information and Protection of Privacy Act, and will be used for the purpose of Dog Licensing and Canine Control. Questions about this collection should be directed to the FOI Coordinator, The Corporation of the Township of Oro-Medonte, 148 Line 7 South, Oro-Medonte, Ontario L0L 2E0.
