To be considered as an adopter you must:

· Be at least 24 (sometimes negotiable) years old.
Be willing and able to spend the time and money to maintain this pet for its natural lifetime.
If you are not a homeowner, we need land lord approval.
The dog you are adopting is a companion animal, it is not to live on a chain, or be ignored while kenneled up. Please do not apply if you are an outdoor only home. We do not adopt to outdoor situations as we are confident that we can find indoor homes for all of our animals.
If you move, you must plan to take the pet with you.
Dogs may not ride in the back of pick-ups un-secured.

Please complete ALL questions and boxes. Leaving questions blank or not filling out this form completely can be cause for the application to be discarded or denied.


To submit, please copy the below application into an email and send to us with your responses. If you have any questions or would like for us to send you the application in Word format, please email us.



Type/Name of dog desired?

Age of dog desired?

Approximate weight as an adult?




Address, City, State, Zip:

How long at your current residence?

Home Phone:

Cell Number:

Email Address:


Employment status:

If employed, list employer and title.

How long at your current job?

Work Number:

How many other adults live in your home?

What are their ages?

How many children live in your home?

What are their ages?

Does anyone living in the home have allergies to pets?

 If yes, please explain.




Cell Number:

Email Address:

Date of birth:

Employment status:


Do you own or rent your home?

If you own your own home, does your home owners insurance, HOA, etc... have any restrictions on dogs such as quantity or breed?

What county you live in?

Do you plan on moving in the near future?

What type of home do you live in?

If a rental, are dogs allowed? Are there any breed restrictions?

What are the size restrictions, if any?

Complex name/address?

Manager/Landlord name and phone number?

Type of Street:

Where will the dog live (not including walks and playtime)?

Where will the dog spend nights?

Do you have a securely fenced yard? If so, what kind. Please be detailed.

What is the height of your fence at the LOWEST point?

Do you have an in-ground pool? Is it fenced off or does it have a stable cover?

Will you allow the dog to run loose? If yes, where?

How many hours per day will the dog be alone?

Where will the dog stay when left alone?

In the absence of the primary caregiver, who will care for the dog?

Under what circumstances would you return the dog?

If for some reason you are not able to care for this pet in the upcoming future, what will you do with this adopted dog?

Have you ever had to return or surrender an animal in the past? If so, please list circumstances.

Have you researched the breed(s) you are interested in?

Are you willing and able to pay veterinary costs of caring for your new pet?

Are you willing and able to take the time to work with the dog on various issues such as house training, chewing or other issues if they arise?

If the dog is not house trained, how will you manage this?
Would you consider obedience training if required or recommended?

How much time are you prepared to allow for your new pet to adjust to your home?

Will you be able and willing to regularly exercise this adopted dog?

Please describe your method of exercise.


Please list current pets names, species and breed, age, sex, spayed/neutered, current on vaccines and if they are indoor or outdoor.

If you currently have dogs, are they on heartworm preventative year round? If no, please explain.

Please list past pets names, species and breed, age at time of separation, years owned, sex, spayed/neutered, current on vaccines and if they were indoor or outdoor.

If you had dogs, were they kept on heartworm preventative? If no, please explain.

Will your new dog be on heartworm prevention?

Please list name and phone number of current vet.

Please list the name and phone number of past vets and/or other vets you have used.

Do you consider your pets a part of the family?

Are you willing and able to take care of this pet for its natural lifetime?


Please list two non-relatives, your relationship to them, phone number and best time to contact.

Is there anything else you would like us to know about you that may help in approving your application?

We receive a percentage from people's purchases at Food Lion to help the dogs. All we need is your MVP # to enroll you. If you would like to provide it to us we need all 12 digits from the back of the card. Including the small ones on either side.

Comments? Questions?