Adoption Application

Name:
Address:
City:
State:
Zip Code:
Home Phone:
Alt Phone:
Email:
Employer:

1.
Why do you want to adopt a greyhound?
2.
Do you have any preferences for gender?
3.
Do you have interest in a particular dog?
4.
5.
6.
7.
8.
9.
10.
11.
12.
Do you rent?
12a.
12b.
What is you landlord's name?
12c.
What is your landlord's phone number?
13.
Do you have any physical restrictions that would affect dog ownership? (for example, mobility issues). This will NOT affect our decision, only helps us match the right dog.
13a.
Please tell us about your physical restriction:
14.
If you have previously owned a greyhound, where did you acquire it?
15.
Please list the type, age, and gender of any other pets you have:
16.
Please list the veterinarian you use (name, address, and phone):
17.
Please provide a personal reference that is not a family member (name, address, and phone):
18.
How many people are in your family?
19.
Do you have children under the age of 16?
19a.
How many children under the age of 16?
19b.
What is the age of your youngest child?
years old
19c.
20.
How many hours a day will the dog be without a human companion?
hours
21.
What is the action level of hour household in general?
22.
How did you hear about Nittany Greyhounds?