Adopter Application

Name *

First Name

Last Name

Phone *

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Employer’s Name *

First Name

Last Name

Employer’s Phone

(###)

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Employer’s Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name *

References should not be family members or roommates.

First Name

Last Name

Phone

(###)

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Name

First Name

Last Name

Phone

(###)

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Name *

First Name

Last Name

Phone

(###)

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If the dog is unavailable, would you be interested in similar dogs? *

Yes

No

What age of dog are you interested in? *

Please select one of the following

I have no preference on age

Young Adult 1 - 3 years

Puppy 2 - 6 months

Young 6 mo - 1 year

Older Adult 3 - 7 years

Senior 7+ years

Is there a specific gender you are looking for? *

I have no preference on gender.

Female dog

Male dog

What energy level would work with your lifestyle? *

**Please note that we require dogs of all energy levels be given adequate exercise and daily walks.

No preference

Mellow - Short, daily walks

Active - Short walks and dog park play

Energetic - Running buddy

Where will the dog spend time alone? *

Please select one of the following

Not Sure

Indoor Crated

Indoor Gated in a smaller area of the house

Indoor Free Roaming

Outdoor

Are you willing to work through unexpected hardships with your pet and hire a trainer if need be? *

***This could include: house training, separation anxiety, socialization, fear, adjustments to other pets (and other pets’ adjustment to the new pet).

Yes

No

Not Sure

How soon do you want to adopt a pup? *

Right away, hand that dog over!

I am thinking probably in the next few days.

I am taking my time, a few weeks is fine

I am browsing, it could be a few months.

I am uncertain, it would depend on me finding the right dog.

If you currently have pets, are they spayed or neutered? *

Please select one of the following

I do not have pets.

I do not believe in spaying or neutering my animals

Some of my pets are spayed or neutered but not all.

All of my pets have been spayed or neutered at the age-appropriate time.

Are your pets up to date on their vaccinations and monthly preventatives? Please select one of the following *

**Monthly preventatives refer to Flea and Tick preventatives such as Frontline or K-9 Advantix as well as Heartworm preventatives such as Heartguard or Tri-Heart

I do not have currently have pets.

I do not vaccinate my animals or give them monthly preventatives.

My animals are up to date on their vaccinations but I do not administer monthly preventatives.

My pets are all up to date on their vaccinations and receive monthly preventatives.

Veterinarian's Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

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Do you currently Rent Or Own?

Rent

Own

If you rent, does your landlord allow pets? *

**Please be prepared to provide copy of lease and proof of landlord approval.

Yes

No

Do you have a yard? *

*** Please note - you do NOT need an outdoor space to adopt a IRWAR dog. Please select one of the following:

Yes, a fenced yard.

Yes, an unfenced yard.

I don't have a yard.

How did you hear about us? *

Please select one of the following

Petfinder

Adopt A Pet

Facebook

Tumblr

Twitter

Newspaper/Magazine

Flier

Friend/Family

Attended IRWAR Adoption Event

Met IRWAR Reps at Other Event

Met Foster on the Street

Word of Mouth

Do you agree to a IRWAR representative conducting a home visit? *

Yes I agree

Have you read and agree to our adoption agreement? *

Yes I agree

Do you agree to pay the adoption fee of $300 if approved? *

Yes I agree

Are you at least 23 years of age? *

Yes I am 23 or older