Fabulous Flunkie Adoption Application

Name:*

Address:*

City:*

State:*

Zip:*

Home Phone:*

Cell Phone:*

Work Phone:*

Email:*

Preferred means of contact:*

Phone

Persons in Household, ages:*

Pets in Household (Please give the names and describe type, breed, spayed or neutered, sex and age of each):*

Are the pets friendly with dogs?

Home:*

Own

Rent

If rental, do they allow dogs:

Yes

Do you have a fenced in yard? If not, how will you allow the dog to relieve itself and get exercise?*

Who will have the primary responsibility for care and training of the dog?*

Is everyone in the household supportive of having a dog in the home?*

How do you plan to discipline the dog when they do something unacceptable?*

Have you ever owned a dog before? Please describe. *

Where will the dog stay at night?*

Where will the dog stay when you are not home?*

What is the longest period of time a dog will be by itself?*

Have you ever had a pet hit by a car? If yes, how will you prevent this from happening in the future?*

Are you willing to wait several months to receive a "released" dog?*

Do you have any concerns or questions about the possibility of adopting a "released" dog?*

Veterinarian Office

Name:*

Phone:*

Positive Reinforcement Trainer

ADAI highly recommends continuing the training process of our released dogs by attending basic obedience classes from a Positive Reinforcement Trainer. This will create a firm bond between you and your new companion. If you have a trainer in mind, please list the following.

Organization/Company:*

Name of Trainer:*

Phone:*

Send required photos to kmakula@adai.org

All fields marked with an asterisk (*) are mandatory.

Thank you for your interest in our program. Your application will be reviewed and an ADAI representative will contact you in the near future.