Fillable DOG SERVICES ADOPTION QUESTIONNAIRE (Columbia Gorge Community College)

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DOG SERVICES ADOPTION QUESTIONNAIRE (Columbia Gorge Community College)

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DOG SERVICES
ADOPTION QUESTIONNAIRE
The Marion County Dog Sh
elter is a non-profit government organization committed to the dogs in our care. We consider pet
ownership a serious responsibility. By adopting, you are making a commitment to care for a dog for the rest of his/her life.
The dog’s welfare is our primary consideration. We ask for your cooperation throughout the process of bringing people and
dogs together. To ensure this pet adoption is in the best interest of you and the dog you select, please provide the following
information.
To adopt a dog, you must be 18 years of age or older and provide photo ID.
(
Staff Only Ref) PID#:
Name: Date:
Spouse/Partner Name: Primary Phone:
Physical Address: Secondary Phone:
City, State, Zip:
Preferred method of contact:
Mailing Address: (if applicable)
County:
Mailing City, State, Zip: (if applicable)
Email Address:
We welcome adopters who rent, or live in an apartment or condo. Some landlords and management
companies have size and breed restrictions, limits on number of pets, and/or require pet deposits
or additional fees. Please check with your property management before adopting a dog.
Number of Adults in household? Ages of children that will ha
ve regular contact with adopted dog?
Pe
t
Ownership History: Please list all of your pets in the last 5 years, including those you no longer have.
Type (dog,
cat, etc.)
Pet’s Name & Breed Age Gender Spayed/
Neutered?
How long
owned?
Still own?
If no, why?
How would you describe your house hold?
○ Very quiet – only a few residents and not too many guests.
○ Average – not too quiet but not party animals.
○ Very busy – lots of people are coming in and out!
Dogs interested in:
email
phone
Do you have prior dog experience?
○
No, this will be my 1
st
dog
○
Yes
If yes, explain any other experience/dogs not listed above in pet ownership history:
Tells us about what would be your ideal dog?
Check the qualities you would like your dog to have.
Example: ● Small ● Medium ○ Large We will read this as you would prefer a small/medium dog, but not a large one.
Physical traits:
○
Small
○
Medium
○
Large
○
Mature/Senior
○
Adult
○
Juvenile
○
Puppy
○ Low-Shedding ○ Hypoallergenic ○ Short Coat ○ Long Coat ○ Professional Groom ○ Daily grooming
Personality:
○
Quiet
○
Talker
○
Barker
○
Calm
○
Low-Energy
○
Playful
○
Energetic
○
Smart
○
Simple
○
Trainable
○
Needy
○
Independent
○
Interactive
○
Outgoing
○
Obedient
○
Lap Dog
○
Cuddle Buddy
○
Travel Buddy
○
Hiking Buddy
○
Food Motivated
○
Super Sniffer
Abilities:
○
Agility
○
Protection
○
Hunting
○
Dog Sports
○
Service Animal
○
Support Animal
○
Therapy Animal
○
Working dog
○
Farm dog
Notes/Anything not addressed above:
___________________________________________________________________________________
___________________________________________________________________________________
What kinds of activities would you like to do with your dog?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
How will your social life or work obligations effect your ability to care for this dog? Explain:
___________________________________________________________________________________________________
___________________________________________________________________________________________________
If you are thinking of adopting a puppy/young dog, do you have the time and patience to work with the dog
through its’ adolescence taking into account house-breaking, chewing and energy level?
○
Yes
○
No
We’ll explain this new dog’s medical history and behavioral history. Are there any other specific topics you would
like additional information on? _______________________________________________________________________
___________________________________________________________________________________________________
I certify that the above is true and understand that false information may nullify the adoption. I understand this is
only a questionnaire and does not entitle me to adopt a dog from the Marion County Dog Shelter. I agree that this
application remains the property of Marion County Dog Shelter.
Signed: Date:
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DOG SERVICES ADOPTION QUESTIONNAIRE (Columbia Gorge Community College)

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Completed 2 August 2020

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