Online Adoption Form

Personal Information

Name:.................

Phone :........

Best Time to Call:.

Email Address:..

Address: ............

City: State: Zip Code:

Age of Applicant:

Occupation:........

How Many People in your Household:....

Adults:...............

Children (How Many and Ages):.............

How Did You Hear about Greyhound Outreach:

Do You Have a Dog Now (Breed,Age,Sex):........

Other Pets (How many and what kind):.............

What Pets Have You Had In The Past and What Happened To Them:

How Long Would Your Greyhound Be Alone per Day:

Dwelling Type: Own Rent Lease

Do You Have a Fenced in Yard: Yes No

Fence Type: Fence Height:

Approximate Size of Fenced Area:.........................

Is It Totally Enclosed/Secure: Yes No

If you don't have a secured fenced area, are you willing to leash walk your greyhound 4_5 times a day for necessary functions and exercise?: Yes No

 

If you rent or lease your home, we are obligated to confirm with your landlord that a Greyhound would be permitted. If applicable, please answer the following questions.

Landlord Information

Name:

Phone:

Address:

City: State: Zip Code:

Veterinarian's Information

Name:

Phone:

Address:

City: State: Zip Code:

Personal or Business Reference

Name:

Phone:

Address:

City: State: Zip Code:

After we receive your application, you will be contacted to set up a home visit as soon as possible. If I adopt a greyhound, I give Greyhound Outreach permission to share my name, number and address with the Lost Dog Cooperative. I understand that my information will be kept confnameential and will only be used by the L.D.C. in conjunction with Greyhound Outreach to help me find my greyhound if it were to get loose or go missing.

I Agree With This