Second Chance Dog Adoption Application
Our mission is to carefully match every dog with the best home for its needs to ensure a long lifetime of safety, love and companionship. There are many applications that are declined for a variety of reasons based on 2nd Chance's many years of experience with dog adoptions. This does NOT mean that any volunteer of Second Chance is making a judgment about an applicant's ability to provide a good home for a dog.
Date:		_______________________________________________
Applicant(s) Name:		_______________________________________________
Address:		_______________________________________________
City/State/Zip:		_______________________________________________
Evening Phone:		_______________________________________________
Day Phone:		_______________________________________________
Cell Phone:		_______________________________________________
Email Address:		_______________________________________________
What dog/puppy are you interested in?		_______________________________________________
What age dog are you looking for?		_______________________________________________
Why do you want to adopt at this time?		_______________________________________________
When did you decide to get a new dog?		_______________________________________________
Please list the qualities you are looking for?		_______________________________________________
If you have a particular 2nd Chance dog in mind when filling out this application, could you please explain why this particular dog is of interest to you; compared to other dogs you've seen or know?		_______________________________________________ _______________________________________________ _______________________________________________
What size dog are you looking for (as an Adult dog, in pounds)?		_______________________________________________
Companion for:
Myself/Family Another Dog Family Member, Friend Gift		_______________________________________________
Please list all of the pets you have had, as an adult:
Species and Name:		_______________________________________________
Spayed/Neutered?		_______________________________________________
Location kept: Indoor/Outdoor:		_______________________________________________
Current Age or if deceased, what happened to them?		_______________________________________________
Species and Name:		_______________________________________________
Spayed/Neutered?		_______________________________________________
Location kept: Indoor/Outdoor:		_______________________________________________
Current Age or if deceased, what happened to them?		_______________________________________________
Species and Name:		_______________________________________________
Spayed/Neutered?		_______________________________________________
Location kept: Indoor/Outdoor:		_______________________________________________
Current Age or if deceased, what happened to them?		_______________________________________________
Species and Name:		_______________________________________________
Spayed/Neutered?		_______________________________________________
Location kept: Indoor/Outdoor:		_______________________________________________
Current Age or if deceased, what happened to them?		_______________________________________________
Vet Clinic/Hospital:		_______________________________________________
Vet's Name:		_______________________________________________
Phone:		_______________________________________________
May we contact them as a reference? If No, please explain:		_______________________________________________
List all of the members in your household, including yourself:
Name and Age:		_______________________________________________
Do they agree with getting a new dog?		_______________________________________________
Any Known Pet Allergies?		_______________________________________________
Name and Age:		_______________________________________________
Do they agree with getting a new dog?		_______________________________________________
Any Known Pet Allergies?		_______________________________________________
Name and Age:		_______________________________________________
Do they agree with getting a new dog?		_______________________________________________
Any Known Pet Allergies?		_______________________________________________
Name and Age:		_______________________________________________
Do they agree with getting a new dog?		_______________________________________________
Any Known Pet Allergies?		_______________________________________________
Name and Age:		_______________________________________________
Do they agree with getting a new dog?		_______________________________________________
Any Known Pet Allergies?		_______________________________________________
Who will be primarily responsible for the care of the dog?		_______________________________________________
**Do you own or rent your residence?		_______________________________________________
If Rent, please answer the following questions:
Does the owner permit the number/size dog(s) you will have?		_______________________________________________
Have you paid any applicable dog/pet deposits?		_______________________________________________
What is the name of the property owner/agent?		_______________________________________________
Contact Name and Phone Number:		_______________________________________________
May we contact the owner and/or its agent?		_______________________________________________
How will the dog be confined to your property when it is outside:
Fence? Electric Fence? Other, explain		_______________________________________________
Where will your dog spend most of its time when you are at home?
Mostly Indoor - Crate or Loose in House Mostly Outdoor - Fenced Yard, Electric Fence, Chain, Tie out or Other		_______________________________________________ _______________________________________________
Where will your dog spend most of its time when you are at work or out?
Mostly Indoor - Crate or Loose in House Mostly Outdoor - Fenced Yard, Electric fence, Chain, Tie out or Other:		_______________________________________________ _______________________________________________
Where will your dog spend most of its time when you are out of town?		_______________________________________________ _______________________________________________
What sort of lifestyle do you want your dog to live?		_______________________________________________
Active, Semi-Active, or Relaxed: Please explain :		_______________________________________________
How will your dog be exercised?		_______________________________________________
How do you plan to train the dog? Myself, Classes, None, Other:		_______________________________________________
When would you allow your dog to run off-leash or in open/unfenced area?		_______________________________________________
**Under what circumstances would you give away a dog or return this dog to us?
Aggressive behavior, Fleas or sheds too much, Moving to another state, Chews or destroys household objects, Children will no longer take of it, Finished school/moving back home, New home doesn't allow pets, Getting a divorce, separated or married, Wrong personality for the rest of the household, Too active, Too expensive, Having a baby, Other:		_______________________________________________ _______________________________________________ _______________________________________________
What do you estimate the average cost of caring for your dog each year?		_______________________________________________
How long would you expect the average, well-cared for dog to live?		_______________________________________________
Would you object if a 2nd Chance volunteer made a follow-up visit after the adoption?		_______________________________________________
How do you know about 2nd Chance?
Posters, Friend, Brochure, N & O Classified Ad, N & O Pet Connections Ad, Independent Ad, TV, Radio, Candy Boxes, Second Chance Website, Petfinder Website, Referral,   Event, Vet, Other:		_______________________________________________
Have you ever applied to adopt a pet from 2nd Chance or any other adoption organization?		_______________________________________________
If Yes, what happened with the application?
Adopted, Didn't find the right pet, Declined, Other, Please explain:		_______________________________________________
ADOPTION PROCEDURES
Second Chance Pet Adoptions' policy prohibits dogs from being adopted directly from a public display. Please allow 2-5 business days to process your application and contact your references. We have found  this also allows you and your family sufficient time to consider the commitment being made as well as prepare your family and home for your new arrival!
If your application is approved, you will be contacted to schedule a follow-up appointment at a mutually convenient time and location. Arrangements will then be made to complete the adoption if all parties agree you are a good match for the dog.
At the discharge appointment, the following requirements must be met: 1.  Bring a collar & leash, or appropriate-sized carrier. The dog will not be released to you unless you bring this appropriate form of transport (NO EXCEPTIONS). 2.  You will receive any medical records and, if applicable, any medications specifically prescribed for the dog. You are expected to take these records to your veterinarian who will help you determine additional scheduled vaccinations, etc. 3.  Either the applicant or any person representing Second Chance, reserves the right to change their minds about the adoption at any time prior to the paperwork being signed, the fee paid, and the release of the dog to the applicant. 4.  Review and sign the Adoption Agreement and pay the Adoption Fee ($175.00). We prefer that you pay by check made payable to "Second Chance Pet Adoptions". You may also be asked to present some form of picture identification. 5.  Especially if this form was submitted electronically, we ask,  if your signature does not already appear below, please review and sign this Adoption Application. By signing this application, you understand that any false, incomplete or misleading statements on this application are grounds for denial of the application and/or the immediate return of the dog to Second Chance.
By hitting the save button below your application will be sent to an adoption counselor for review.  This button does NOT save the application to your computer.  Thank you!