Cabarrus Pets Society
First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
County
Email*
Home Phone*
Cell Phone
Date of Birth *
Which dog are you interested in? Choose an animal: Daisy Mazie Moozie Mr. Handsome
What is your current employment status?* Choose one: Employed Full Time Employed Part Time Unemployed Retired
Occupation?*
Do you own or rent your home?* Choose one: Own Rent
Do you have plans to move in the near future?* Choose one: Yes No I don't know
How long have you lived at your current address?*
What type of home do you live in?* Choose one: Apartment Condo Farm House Mobile Home
Do you live inside of city/town limits?* Choose one: Yes No
Do you have a fenced yard?* Choose one: Yes No
What type of fence? Choose one: Privacy Chain Link Invisible
How high is your fence?*
If you rent, does your lease agreement allow dogs or cats? Choose one: Yes No
Does your lease have pet restrictions based on size or breed?* Choose one: No Not Applicable Yes
If your lease has pet restrictions, please describe:
If you rent, how much is your pet deposit and monthly pet fee?
Landlord's name (If an apartment or 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
Do children live in the home?* Choose one: Yes No
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
Do children visit your home regularly?* Choose one: Yes No
Do any pets visit your home regularly?* Choose one: Yes No
Is anyone in your home allergic to dogs and/or cats?* Choose one: Yes No I don't know
Are all members of your household in agreement about adopting a pet?* Choose one: Yes No
Is someone home during the day?* Choose one: Yes No
Please list all current pets in your household, including name and type of animal (e.g. Sparky, dog). If none, please type "none".*
Please list any other pets you have owned in the past 10 years, including name and type of animal. If none, please type "none".*
Please list the name and phone number of the CURRENT (or most recent) veterinarian that has provided care to your pets.
Please list the name(s) and phone number(s) of all veterinarians that provided care in the PAST 10 years.
The veterinary records are under what owner's name and phone and phone number? (If not sure list all possibilities)
If required by your veterinarian, will you call to give permission to release information about your pets to a volunteer from Cabarrus Pets Society? (PLEASE CALL AND GIVE THEM PERMISSION NOW. YOUR APPLICATION WILL BE DELAYED IF WE ARE UNABLE TO SPEAK WITH YOUR VETERINARIAN) Choose one: Yes No
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?*
Where will your pet(s) stay when alone?*
Where will your new pet(s) sleep?*
Who will be the principal caretaker of your new pet?*
Do you consider your pet a part of your family?* Choose one: Yes No I don't know
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 you willing to fence all or part of your yard if necessary for your new dog?* Choose one: Yes No
Will you attend obedience classes with your new pet?* Choose one: Yes No I don't know
How do you plan on training your new pet and what methods do you plan on using?*
Will you attend obedience classes with your new pet if recommended or required in order to provide the best match possible for you and your new pet?* Choose one: Yes No
Are you willing to housetrain a dog?* Choose one: Yes No
Do you understand that even if a dog is housetrained at his foster home, it is normal for him to have accidents while adjusting to his new home?* Choose one: Yes No
Do you have a plan for your dog when you go on vacation or need to leave town for another reason?* Choose one: Yes No
If so, what are your plans?
How much time do you want to spend grooming your new dog?* Choose one: little to no brushing required 5-10 minutes monthly 5-10 minutes weekly 5-10 minutes daily over 15 minutes daily daily brushing & monthly groom
How much time do you want to spend exercising your new dog? * Choose one: no daily execercise 20 minutes or less daily 20-30 minute walk daily 30-60 minute walk daily 30-60 minute run daily more than 30-60 minutes daily
It is common for a dog to live 10-15 years or more. Are you ready to commit to a dog for that long?* Choose one: Yes No I don't know
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:
Do you have a plan for your pet in the event something happens to you and you are no longer able to care for it?* Choose one: Yes No
Routine medical care for a dog can cost over $300 a year. This does not include emergency care, and other expenses like food, toys, and training. Can you commit financially to a new pet?* Choose one: Yes No I don't know
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.
How did you hear about us?* Choose one: Petfinder 1-800-save-a-pet Website Newspaper Flier Word of Mouth Other
