Cabarrus Pets Society
First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
County
Email*
Home Phone*
Cell Phone
Alt Email
Date of Birth *
Name of spouse or partner-
Please fill out the application COMPLETELY. An incomplete application will cause a delay in processing.
Which dog are you interested in? Choose an animal: Ben Delanie Dior Maasai San Tyra
Do you own or rent your home?* Choose one: Own Rent
What type of home do you live in?* Choose one: Apartment Condo Farm House Mobile Home
Does your homeowner's association or insurance and/or city have restrictions on breeds, size and number of pets? (If yes, please check with them)
Do you have a fenced yard?* Choose one: Yes No
What type of fence? Choose one: Privacy Chain Link Invisible
If you have a fence, what is the height? Choose one: 3 foot - 5 foot 6 foot - 8 foot Over 8 foot
If you rent, does your lease agreement allow dogs and cats and are there restrictions? Choose one: Yes No I don't know
Landlord's name (If a complex, list manager's name and/or rental office)
What is your landlord's phone number?
What is your landlord's email address?
How many adults live in your home?* Choose one: 1 2 3 4 5 6 7 8 9 10
How old are the children in your home? Choose all that apply: No children 0 - 6 years old 7 - 12 years old 13 - 18 years old
What is your families lifestyle and activity level? Choose all that apply: Active and on the go Lots of kids in and out Entertain frequently Travel frequently Quiet and relaxed
Is someone home during the day?* Choose one: Yes No
Do you have a home based daycare, babysit or have children visit?* Choose one: Yes No
My pets vet records are under what name and phone number? (If not sure list all possibilities)
List all current pets by their name and what type of animal they are(e.g. Sparky, dog).
List the name of your CURRENT (or most recent) veterinarian
Your current vet's phone number is
List any pets you have owned in the past 10 years that you no longer have by name and type of animal.
List the name and phone numbers of all veterinarians used within the PAST 10 years. (list all regular and emergency vets)
What traits/characteristics/habits are you looking for in your new pet?*
What traits/characteristics/habits do you NOT want in your new pet?*
Primarily lives* Choose one: Both inside and outside Inside Outside Outside in a fenced area Outside on a chain or leash
How will you contain your dog while outside for bathroom breaks and exercise?* Choose one: Fence Leash Walk Tie to porch, doghouse, tree, Cable tie-out or runner No Containment
How long will the pet(s) be alone each day?*
Will you have your pet spayed or neutered?* Choose one: Yes No
Will you keep your dog current on heartworm prevention medication?* Choose one: Yes No
Are your current pets up to date on their vaccinations and monthly preventatives?*
Are you willing to housetrain a dog?* Choose one: Yes No
Have you ever had to euthanize a pet?* Choose one: Yes No
If yes, please explain
Have you ever had to return or surrender an animal in the past?* Choose one: Yes No
If yes, please explain:
If for some reason you are not able to care for this pet in the future, do you have a plan for someone to take over and care for your pet?* Choose one: Yes No
If the dog you are interested in is no longer available, would you like to hear about other dogs that might be a good match for your family?* Choose one: Yes No
Please list any additional information you would like us to consider when reviewing your application, or list any questions you have below.
List two (2) references including name, phone number, and email. (No family members)*
Before submitting your application
Please u nderstand that submitting an application does not mean you are committing to a dog or cat, nor does it guarantee you will be approved to adopt from Cabarrus Pets Society Rescue.
