Online Application | Ozzies Pound Puppies

Dog's Name *

Date *

mm/dd/yy

Full Name *

Age

Address *

Street Address

Address2

Apt, 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 applicable

3rd Phone Number (if Applicable) *

Type N/A if not applicable

Email *

Are you presently

Employment 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 *

Number of people in the household? *

Include yourself

If 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 *

Do you have a fenced yard? *

If yes, how high (type n/a if not applicable) *

Do you *

If other, please explain *

Type N/A if not applicable

If 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 applicable

Does anyone in the family/home have a known allergy to dogs? *

Is everyone in agreement with the decision to adopt a dog *

How 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 *

Are you willing to take the time to work with your new dog on housebreaking, chewing, etc? *

Other Pets: Have you had pets in the last 5 years *

If Yes, how many *

Type 0 if not applicable

Name of Pet *

Type N/A if not applicable

Type *

Type N/A if not applicable

Years owned *

Type N/A if not applicable

Spayed/Neutered *

Where is pet now *

Type N/A if not applicable

Name of Pet *

Type N/A if not applicable

Type *

Type N/A if not applicable

Years Owned *

Type N/A if not applicable

Spayed/Neutered *

Where is pet now *

Type N/A if not applicable

Name of Pet *

Type N/A if not applicable

Type *

Type N/A if not applicable

Years owned *

Type N/A if not applicable

Spayed/Neutered *

Where is pet now *

Type N/A if not applicable

Are these pets up to date on vaccines *

Microchipped *

Have you ever surrendered a pet *

If so, why *

Type N/A if not applicable

Have you ever had a pet euthanized *

If so, why *

Type N/A if not applicable

Have you ever lost a pet to an accident *

If so, please explain *

Type N/A if not applicable

Have you ever had to re-home your pets *

If so, why *

Type N/A if not applicable

Veterinarian Do you have a regular veterinarian *

Do you agree to provide regular health care by a licensed veterinarian *

Veterinarian'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 applicable

Clinic 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 2

Apt, 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 *

If you stated both or other please explain *

Type N/A if not applicable

Hours/timeframes the dog will be left alone *

Type N/A if not applicable

Who and where will the pet be kept and looked after when you are not at home. *

Type N/A if not applicable

Who will have primary responsibility for this dog's daily care *

Do you consider a pet part of the family *

If no or other please explain *

Type N/A if not applicable

Do you agree to contact Ozzies Pound Puppies if you can no longer keep or care for this dog *

If no, why *

Type N/A if not applicable

Personal References: Please list someone who is familiar with you and your pets: Name

Address2 *

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 applicable

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