Online Application Please enable JavaScript in your browser to complete this form.Dog's Name *Date *mm/dd/yyFull Name *AgeAddress *Street AddressAddress2Apt, Suite, Bldg. (optional)City *State / Province / Region *Postal / Zip Code *Country *How long at this address *Best Phone Number *2nd Phone Number (if Applicable) *Type N/A if not applicable3rd Phone Number (if Applicable) *Type N/A if not applicableEmail *Are you presentlyChoose OneEmployedNot EmployedUnemployedRetiredStudentEmployment Information (Include Name, Address of Employer/School, and hours you work/go to school) *Type N/A if not applicable Family & Housing: Type of Residence *Choose OneHomeCondoApartmentMobile HomeRanch/FarmNumber of people in the household? *Include yourselfIf children are in the home what are their ages? *Separate with commas (i.e. 2, 12, 14, etc) Type N/A if not Applicable.Please describe your household *Choose OneActiveNoisyQuietAverageDo you have a fenced yard? *Choose OneYesNoIf yes, how high (type n/a if not applicable) *Do you *Choose OneOwnRentOtherIf other, please explain *Type N/A if not applicableIf you are renting please provide your landlord's contact information (name, address, phone number) (by providing this information you are allowing Ozzies Pound Puppies to contact your landlord, please inform them of this call so they will speak to us) *Type N/A if not applicableDoes anyone in the family/home have a known allergy to dogs? *Choose OneYesNoIs everyone in agreement with the decision to adopt a dog *Choose OneYesNoHow much time are you prepared to allow your new pet to adjust in your home *Are you willing to pay vet cost of caring for your new pet *Choose OneYesNoAre you willing to take the time to work with your new dog on housebreaking, chewing, etc? *Choose OneYesNoOther Pets: Have you had pets in the last 5 years *Choose OneYesNoNot ApplicableIf Yes, how many *Type 0 if not applicableName of Pet *Type N/A if not applicableType *Type N/A if not applicableYears owned *Type N/A if not applicableSpayed/Neutered *Choose OneYesNoNot ApplicableWhere is pet now *Type N/A if not applicableName of Pet *Type N/A if not applicableType *Type N/A if not applicableYears Owned *Type N/A if not applicableSpayed/Neutered *Choose OneYesNoNot ApplicableWhere is pet now *Type N/A if not applicableName of Pet *Type N/A if not applicableType *Type N/A if not applicableYears owned *Type N/A if not applicableSpayed/Neutered *Choose OneYesNoNot ApplicableWhere is pet now *Type N/A if not applicableAre these pets up to date on vaccines *Choose OneYesNoNot ApplicableMicrochipped *Choose OneYesNoNot ApplicableHave you ever surrendered a pet *Choose OneYesNoNot ApplicableIf so, why *Type N/A if not applicableHave you ever had a pet euthanized *Choose OneYesNoNot ApplicableIf so, why *Type N/A if not applicableHave you ever lost a pet to an accident *Choose OneYesNoNot ApplicableIf so, please explain *Type N/A if not applicableHave you ever had to re-home your pets *Choose OneYesNoNot ApplicableIf so, why *Type N/A if not applicableVeterinarian Do you have a regular veterinarian *Choose OneYesNoDo you agree to provide regular health care by a licensed veterinarian *Choose OneYesNoVeterinarian's Name *If you do not have a current veterinarian please list the name of where you plan to take your new pet. Years you have gone to this veterinarian *Type N/A if not applicableClinic Name *If you do not have a current veterinarian please list the name of where you plan to take your new pet. Veterinarian's Address *If you do not have a current veterinarian please list the address of where you plan to take your new pet. Street Address Veterinarian's Address 2Apt, Suite, Bldg. (optional)City *State / Province / Region *Postal / Zip Code *Country *Phone *If you do not have a current veterinarian please list the phone of where you plan to take your new pet. About the Dog You Wish To Adopt: What is your ideal dog and why *Breed(s) you would not adopt and why *Where will the dog live and spend the night *Choose OneInsideOutsideBothOtherIf you stated both or other please explain *Type N/A if not applicableHours/timeframes the dog will be left alone *Type N/A if not applicableWho and where will the pet be kept and looked after when you are not at home. *Type N/A if not applicableWho will have primary responsibility for this dog's daily care *Do you consider a pet part of the family *Choose OneYesNoOtherIf no or other please explain *Type N/A if not applicableDo you agree to contact Ozzies Pound Puppies if you can no longer keep or care for this dog *Choose OneYesNoIf no, why *Type N/A if not applicablePersonal References: Please list someone who is familiar with you and your pets: NameAddress2 *Apt, Suite, Bldg. (optional) City *State / Province / Region *Postal / Zip Code *Country *Phone *Relationship to this person and years known *Name *Address *Street Address Address 2 *Apt, Suite, Bldg. (optional) City *State / Province / Region *Postal / Zip Code *Country *Phone *Relationship to this person and years known *Is there any other information you wish to provide that will help us in determining your eligibility for pet adoption *Type N/A if not applicableCommentSubmit