Adoption Application Dog InformationPlease enter the information about you and the dog you might want to adopt.Name of Dog to Adopt* Foster Parent* Kratika Leeann Lisa Sheilly Tammy Do you have previous experience with this breed?* Yes No Where will the dog be during the day?* Where will the dog be at night?* How many pets do you currently have?* Have you ever raised a puppy before?* Yes No Have you had previous pets?* Yes No Why are they no longer with you?* Applicant InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Mobile PhoneWork PhoneEmail Address* Over 21?* Yes No Housing InformationType of home?*Single Family HomeDuplexCondoApartmentOwn or lease?* Own Lease If you lease, do you have permission to own a dog?* Yes No Landlord Name* First Last Landlord Phone*Fenced?* Yes No Fence Height* Fence Type* Yard Size* Swimming pool?* Yes No Household InformationNumber of people in household* Number of adults* Number and ages of children* Hours worked per week* Is anyone in household allergic to pets?* Yes No Please tell us more about you and your family and what you are looking for in a dog. If you have any additional comments please also add them here.*Captcha