Rescue Dog Adoption Application

ORPHANED PETS INC.

ADOPTION APPLICATION
PO Box 1945, West Caldwell, NJ 07007

Hot Line: 973-882-8363
Orphaned Pets Inc. was founded in 1990 with the objective to Rescue, Foster and Adopt unwanted domestic pets into loving homes.
Applicant Information
Name of the dog you are interested in: *
Your full name: *
Street Address: *
City, State, Zip *
Home Phone:

Area Code Phone Number
Cell Phone:

Area Code Phone Number
E-mail:
Household Information
Are all members of your household in agreement with this adoption? *

Yes No Don't Know
Who will be the pet's primary caregiver? *
Do you live in a *

House Apartment Condo Mobile Home
Do you own or rent? *

Own Rent
Does your landlord allow dogs?

Yes No
Are there any restrictions from your landlord or subdivision? *

Number of pets Size or weight restrictions Breed restrictions None
Do you have a fully fenced yard? *

Yes No
How many adults are in your household? *
How many children are in your household? *
If children, what are their ages?
Current/Previous Pet Information
List any pets you own or have owned in the past five years, and their ages
How many of these pets are spayed/neutered?
Where are these animals now?
Have you ever given up a pet?

Yes No
If yes, what were the circumstances?
Please provide the name and phone number of your current and/or previous veterinarian or clinic:
New Pet Information
Are you aware of crate training? *

Yes No
Have you ever house-broken a dog or puppy before? *

Yes No
If the dog has an "accident" in your home, what type of correction do you plan to use? *
How many hours each day will your new pet be home alone? *
Are you willing to work through your new pet's issues, if any? *

Yes No
Do you plan to take an obedience class with your dog? *

Yes No Not sure
How did you find out about Orphaned Pets Inc.? *

Adoptapet.com Petfinder.com Facebook Friend/Family Member Other website PetSmart
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
Signature:
Should be Empty:

ORPHANED PETS INC.

PO Box 1945, West Caldwell, NJ 07007

Orphaned Pets Inc. was founded in 1990 with the objective to Rescue, Foster and Adopt unwanted domestic pets into loving homes.

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information