Shelter Puppies, Inc ^ Application for Adoption

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1 Shelter Puppies, Inc ^ Application for Adoption Spouse/Sig. Other Date Phone Mailing How long at current address Own Rent Live With Someone (name) House Trailer Apartment Condo Other of Trailer Park _ Rural/Country Have Yard Fenced Pen If you rent, list the Landlord/Property Owners,, Phone,, Phone of closest relative or friend Employer How long employed Employer, Phone If Self Employed, name and type of business How long self-employed Retired Social Security Pension SSI Spouse/Significant Others Employer,, Phone How Long Employed Number of Children Living at Home Ages Why do you want this puppy? Do you plan to keep the puppy indoors or outside? If outside, why?

2 Where will the puppy spend most of it's time? Where will it sleep? Do you plan to use a crate? Why/why not (crate) If you go on vacation, who will care for the puppy? If you move, will you take the puppy? What if they do not allow pets? What will you do with the puppy then? What will you do if the puppy/dog runs away or gets lost? Do you already have a Veterinarian? Vet,, Phone Do you keep your dog on heartworm preventative? Have you owned a dog that got parvo, distemper, or died from an unknown cause/illness in the past year? Are you willing to assume the responsibility of a lifetime of care for this puppy? How many pets do you currently own? Dogs Cats Other If none, when was the last time you owned a pet? What happen to it? How many live In the house? ' List dog breeds, ages, and if spayed/neutered How did you hear about Shelter Puppies? Would you like to receive informational s from Shelter Puppies, such as up-coming events & care tips? Will you allow follow-up visits by a Shelter Puppies representative?

3 References Please do not list relatives or people living in the same home as you.

4 Puppy Information Puppy Date of Birth Breed Color Microchip Number Terms and Conditions The terms "I", "they", and "Adopter" are herein referring to the person adopting the puppy from Shelter Puppies, Inc. The terms "We" and "Shelter" are herein referring to Shelter Puppies, Inc and/or Shelter Puppies, Inc representatives. Adopter/s understand/s that the Shelter may not approve this application. Adopter agrees to a home visit by a Shelter representative prior to placement of a puppy in the Adopters home, and to occasional visits once the puppy has been placed in the Adopter's home. Adopter understands that the heritage of the puppy being adopted from Shelter Puppies, Inc is most likely unknown, and therefore Shelter Puppies, Inc CANNOT guarantee the genetic health nor the temperament of the puppy. Adopter understands that they are solely responsible for the puppy/dog's actions once the puppy leaves the hands/care of the Shelter. Adopter agrees to provide adequate food, water, and shelter, as well as love, proper veterinary care, socialization, and training for the puppy. Adopter agrees to be fully responsible for, and provide, all future health care of the adopted puppy, to Include, but not limited to, vaccinations, medications, routine, and emergency vet care. Adopter understands that the puppy has been microchipped for the purpose of permanent Identification for both the Adopter and the Shelter, and that the Shelter will provide owner information to veterinarians, law enforcement, and/or other shelters, when/if it is deemed necessary by the Shelter..Adopter understands that $ of any made deposit/s is non-refundable and non-transferable. Adopter understands fully that if the puppy/dog is returned or surrendered, either willingly or by legal means, there will be NO refund, retribution, or financial reimbursement paid to the Adopter. Adopter agrees to keep up on, and advance, the foundational training the puppy has received prior to placement In the Adopter's home, with additional/continuing training to begin within 6 months of placement in Adopter's home. i,, the Adopter listed on the first page of this Application for Adoption, certify that the information I have provided is true and correct. I further agree that I have read, fully understand, and agree to be bound by the terms and conditions listed above, and understand that failure to comply may result in forfeiture of the adopted puppy/dog. I will obey federal, state, and local laws pertaining to my new puppy, and agree that I will not loan, sell, trade, or barter the puppy/dog to another person or agency, nor will I use or allow the puppy/dog to be used for experimentation, fighting, or illegal purposes.

5 I agree that if I can no longer care for/keep the adopted puppy/dog, I will find a suitable home and will notify the Shelter immediately, and will provide the new owners' name, address, and phone number, or I will arrange to personally return the puppy/dog to a Shelter representative. Adopter's Signature ; Date Shelter Puppies Adoption Contact Information Randy Wilson, Adoption Coordinator 1700 Warner Ave Mineral Ridge, OH ranjay34(a)msn.com Shelter Puppies, Inc W PO Box 522, Cortland, OH 44410

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