Dog’s name ______________________________ Kennel # ____________________
Please answer every question in order for your application to be considered. Completing an application is not a guarantee of adoption.
Name: _______________________________________
Street address: _____________________________________ City, State, Zip: ________________________________
Home phone number: (____) _______ - _______ Cell number: (_____) _______ - _________
Email: __________________________________ (Email will only be sent for notification of special events)
Are you the head of household? (If no, the head of household must be present when turning in the application)
Please list ALL of the pets you have had in the past 5 years and those you currently own.
Type/Breed Age Sex Spayed/Neutered Licensed Where is this pet now?
(yes or no) (yes or no) (If pet died, please list at what age and reason)
What is the reason for adopting this dog? (Check all that apply)
Personal or family companion ____ Companion for other pet ____ For children ____ Gift ____ Guard dog ____
What characteristics are you looking for in a dog? (Check all that apply)
___ Active ___ Affectionate ___ Mellow ___ Quiet
___ Playful ___ Independent ___ Outgoing/Sociable ___ Lap dog
___ Good with other dogs ___ Good with other animals ___ Good with children
Do you live in a: House ____ Townhome/Condo ___ Apartment ____ Duplex ____ Mobile home ____
Do you: Own ____ Rent ____ Landlord Name/Number: _______________________________________________
Are you prepared to pay any required pet deposits or pet rent? ______________________________________________
If you move (locally, out of state, or out of the country) what will you do with this dog? __________________________
Do you have a fenced: Yard ____ Patio ____ Both ____
If you do have fencing, what type is it? _________________ What is the fence height at the lowest point? ___________
Do you have a pool? _________ If yes, is the pool gated? _________________________________________________
How many adults are in your household? ______ Ages: ____________________
How many children? ______ Ages: ________________________
Has every member of your household agreed to adopt this dog? _____________________________________________
If this has not been discussed at great length, please complete application when that has occurred.
Does any member of your household have allergies or asthma? _____ If yes, please describe: ___________________
What is the activity level in your household? Mellow (quiet) ____ Moderate ___ Active (loud, busy) ____
Is someone home during the day? ___________ If so, who? _______________________________________________
How many hours will this dog be alone each day? ______________________________________________________
Where will this dog be kept when it is left alone? ________________________________________________________
Where will this dog be kept when you are home? ________________________________________________________
Where will this dog sleep at night? ___________________________________________________________________
Who will care for this dog when you are on vacation or out-of-town? _________________________________________
The annual cost associated with providing responsible care (vaccinations, medical care, boarding, supplies, etc.) to a
healthy dog is approximately $800. Do these costs present any financial problems for you? _______________________
Are you willing to potty train this dog if needed? ___________
Are you willing to take this dog to training classes if needed? ________ If yes, do you know where? _______________
Are you prepared to make a commitment of 10 to 18 years to this dog? _______________________________________
Which reasons may prompt you to relinquish, return, or rehome your dog? (check all that apply)
___ Illness ___ Allergy ___ Moving ___ Potty accidents/unable to potty train
___ Biting ___ Growling ___ Marking in house ___ Chewing/destructive behavior
___ Too active ___ Fencing jumping ___ Hides for a week ___ Digging
___ Barking ___ Non-compatible with other pets ___ None
___ Other (explain) __________________________________________________________
Have you ever had to give up a pet? ___________ If yes, when and why? _____________________________________
If your dog gets sick, what will you do? ________________________________________________________________
Do you have a current veterinarian? ____ If yes, list name and phone number: _________________________________
Have you adopted any animals from Mission Viejo Animal Services before? ___________________________________
If yes, do you still have this/those animal(s)? _________________________
Have you completed an application to adopt an animal from our shelter in the past 12 months? ____________________
If yes, which animal (name)? ____________________________________________________
Your application will be reviewed along with all others received by Animal Services personnel to ensure that the best
home possible is selected for this animal. Animals are NOT adopted solely on a first comefirst served basis. The
completion of this application is not a guarantee of adoption.
Incomplete applications forms are grounds for denial of adoption
We Reserve the Right to Refuse the Adoption of any Animal
I hereby certify that the above answers are true, to the best of my knowledge, and I understand that if approved, I must
sign and abide by an Adoption Agreement.
Applicant Signature
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