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Lifeline Dog Rescue
Lifeline Dog Rescue Adoption Form
First name
Last name
Email
Phone
Alternative Phone number
Birthday
Month
Month
Day
Year
Address
City, State Zip code
Confirm the address listed above is the address dog(s) will be living at?
Number of Children
Ages of Children
Type of Home?
Home ownership?
Do you have a fenced in yard?
List of current pets (Breed, age, gender)
List of other pets you have owned in the past 10 years?
Name of dog you are wanting to adopt?
Are you familiar with the breed you are wanting to adopt?
Do you crate your dog(s)?
How many hours would your dog be alone?
Name of Veterinarian and phone number?
Recreational plans for your dog?
Where would your dog stay if the family travels?
If you have to surrender your dog at any point do you promise to surrender the dog back to Lifeline Dog Rescue?
How did you hear about Lifeline Dog Rescue?
Will you grant permission for Lifeline Dog Rescue or their representative to visit your home?
Please explain why you have chose this dog and what purpose it will serve for your family?
Submit
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