Dog Adoption Application

Housing Conditions
Do you live in a:*
Photo of Housing*

Upload a File
Please provide a photo of the front of your house. Cancelof
Do you:*
If Renting:
Landlord will be contacted to ensure that pets are allowed.
Do you have a fenced yard?*
If Fenced:*
Material, height, # of lockable gates, etc.
If in an apartment:*
Is the apartment pet friendly?
Fenced/Pet living area Photo #1*

Upload a File
Photo of the ENTIRE (all sides) containment area. keep photo under 1000kb size. Cancelof
Fenced/Pet living area Photo #2*

Upload a File
Please upload a photo of the gate to the containment area. keep photo under 1000kb size. Cancelof
Fenced/Pet play area Photo #3*

Upload a File
Please upload any additional photo of containment area. keep photo under 1000kb size. Cancelof
If for any reason you are unable to upload the photo you wanted, upload a super small file size of something else. You can then email the photo you actually wanted to upload to gina@nscrescue.org

Our sinceres apologies for any inconveniences.

Household Info
How many people in your household, including yourself?*
Anyone in your household have allergies to animals?*
Activity level in your home:*
Any previous pets you have had? Any current pets?*
Gender, age, type, neutered/spayed, vaccinated, obedience classes, behavior

Veterinarian Info
Veterinarian Name

First NameLast Name
Clinic's Name*
If you do not have a vet yet, please provide a clinic you would be taking the animal to for check-ups.
Phone Number*

Area CodePhone Number

Terms, Conditions, & Signature
Are you willing to have a NSC rep do a home visit?*

YesNo
Are you willing to participate in the required 4 weeks of training at Clearwater Dog Training (CWDT) as part of the adoption process through Nikeno's?*

YesNo
Please read carefully

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully. I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in denial of adoption. I certify that the above information is correct, and I understand that the information will be verified. I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Nikeno's Second Chances and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the adopted pet. I agree to have Nikeno's Second Chances complete reference call checks and conduct a home visit inspection if applicable to be able to approve my adoption application.
Signature*

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Rescue Animal Info