Landlord's Name, Address, and Number
Are you or any members of your household allergic to animals? If yes, please describe.
Do you travel for business or leisure? If YES, who will care for your animal(s) while you are away?
Describe Your Neighborhood: Is it a City, Town, Suburbs, Rural?
Please read and check off the fields below:
Check if you have considered the daily expenses for maintaining an animal (food, vaccinations, monthly heartworm preventative, monthly flea/tick preventative, spay/neutering, unexpected medical expenses, grooming, obedience classes, etc.)
Check if you agree to license and provide total health care for this dog
Check if you agree to do a home visit as a part of the adoption process
Check if you agree to contact Shultz's if you cannot keep this dog
If not, please explain why:
Are you willing to adopt:
Dog that needs regular medication
Dog that needs regular grooming
Current & Former Pet History:
Please complete the following information regarding all current animals living in your home as well as former animals: Current and Fomer Dogs: Please include breed, sex, age, disposition, and length of ownership.
Current and Former Cats: Please describe if they are dog savvy or have interacted with dogs previously.
Please explain the circumstance and reasoning for the surrender:
Please note as a part of the adoption process we will be contacting your vet to validate your pet's health records.NOT owned a pet recently, please list the name of the veterinarian you used when you owned your last pet or one you are planning on using.Check if your current pets are spayed or neutered
Check if your pets are current on vaccines, heartworm prevention and flea/tick prevention.
Where will this dog spend its day?
Where will this dog spend its night?
When the dog goes out, how do you plan to supervise?
Check if you intend to crate the dog
Please describe your plans for training/discipling the dog
List the Names and Phone Numbers of 2 non-family referenceswe may call who can attest to your suitability as an adopter
How Did You Hear About Us?
We encourage adopters to consider their own needs, preferences, and capabilities before adopting any dog. Submit Application
Thank you for submitting your application! You will bereceiving a confirmation email that your application has been submitted.
