Dog Shelter Adoption Application

GUERNSEY COUNTY DOG SHELTER ADOPTION APPLICATION

Address *
Address
City
State/Province
Zip/Postal
Do you own your home? *
If you rent, do you have permission form the Homeowner to have a dog?
Do you have children in the home? *
Is this animal being adopted for yourself? *
Have you owned a dog before? *
Do you currently own a dog? *
Do you have a current dog license?
Are your current pets up to date on Dhlpp/Rabies Vaccines? *
Is anyone in the home allergic to animals? *
Are you willing to work on housebreaking and obedience? *
Do you understand it will take time for this animal to adjust? *
Do you agree to give this animal time to adjust? *
Do you have a fenced in yard or kennel? *
Is this dog going to be kept outside? *
I agree that I will be responsible for proper care of this dog, which includes: veterinary care, proper diet, grooming and proper exercise? *
I am aware that from the time of adoption, I am responsible for any medical care the animal needs and that the Guernsey County Dog Shelter will not be responsible for any medical care or expense should the animal become ill? *
Do you have a steady income to provide for the new dog? *

Current Veterinarian Information: 

Please check with your Vet prior to submitting your application to see if they require authorization before releasing of records. If we are not able to retrieve records, we will move on to the next application.

By submitting this application, I acknowledge that all information on this application is true and correct. I understand that any misrepresentation of fact may result in refusal of adoption privileges to me. Please allow 48 to 72 hours for your application to be processed.
Do you agree to the above?