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Adoption Application
Applicant Information
First Name:		Address:
Last Name:
Employer:
Occupation:		City:		State: ZIP:
Birthdate:
Cell Phone:		Home Phone:
Work Phone:		Other Phone:
Email Address:
Spouse or Significant Other
First Name:		Last Name:
Employer:		Occupation:

Home Environment
Describe Your Family
Number of adults?	How many children?
Are you currently expecting a child? Yes No	Are you planning on having a child in the next 10 years? Yes No
Is anyone in your family allergic to dogs? Yes No
Please list the children's ages (if applicable) and a few details about your family
If you have children, how do you plan to prepare your children for the addition of a dog to their family?
Please explain how you would resolve issues with your children and the new dog?
About your Home
What type of home do you live in?	Do you rent or own your home?
If you are renting please enter your landlord's name and contact information
If you rent do you have permission from your landlord to have a dog? Yes No	Is there a weight limit for pets where you live? if so what is it?
Do you have a fenced in area? Yes No
If you have a fence could you elaborate on it's type, height, and the enclosed area.
Do you live near a dog park? Yes No	If so would you plan on taking your new dog there? Yes No
Other Pets
Do you currently have any pets? Yes No
Please describe the type, breed, sex, and age of your current pets
Are your pets shots current? Yes No N/A	Are your pets spayed or neutered? Yes No Mix N/A
If not all of your pets are spayed or neutered, please explain why they aren't.
Are any of your pets on heartworm treatment? Yes No N/A	Are your pets on flea/tick preventative medication? Yes No N/A
Do you have the proper facilities to keep the Saint separate from your other pets if a situation arises?
Please provide the name, address, and phone number of your veterinarian
If you have had dogs that have passed away, please explain when and the circumstances
The Daily Routine
How long will the dog be alone during the day?	Where will the dog be kept when left alone?
Where will the dog be kept during the day?	Where will the dog be kept during the night?
Where do you board your pets while away?	Do you have a crate to keep the dog in? Yes No
Will you groom the saint on a regular basis? Yes No
Adoption Information
Basic Information
How soon are you looking to adopt?	Have you applied to adopt with us before? Yes No
If you have applied before what was the outcome?	If you have applied before when did you apply?
Dog Preferences
Is there a specific dog that you are interested in?	What coat length do you prefer?
What sex do you prefer? No preference Males Females	What energy level would you prefer?
Are you willing to take a saint who hasn't been housebroken? Yes No	Are you willing to take your new dog to obedience training? Yes No
Are you willing to allow a home inspection prior to adopting? Yes No	Are you willing to allow a home inspection after adopting? Yes No
Miscellaneous
Are you aware that the dog will shed and drool? Yes No	Have you ever owned a Saint Bernard before? Yes No
What lead you to the decision to adopt a Saint Bernard?
Are you aware that all dogs coming from the rescue will be spayed or neutered? Yes No
If you have any issues with our spay/neuter policy please explain
As Saints age they may require extra attention including but not limited to: - Providing your dog with more frequent opportunities to use the bathroom - Providing your dog with more padding in his/her bedding as old age sets in - Providing your dog with mediciation for symptoms of arthritis - Adjusting your routine to allow your dog to avoid stairs later in life? Have you considered how your life may change based on the needs of your dog? Yes No
Are you aware of the adoption fee? Yes No	Are you able to pay the adoption fee? Yes No
How did you hear about the rescue?

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midatlanticsaintbernardrescue@gmail.com