>
Contact Information
Your New Dog
Select One:
Indoors only
Outdoors only
Indoors and Outdoors
Indoors w/special cat room
Select One:
Yes
No
Pet Information
Select One:
No fenced yard
Chain link fence
Block wall
Wood slat
Other
Select One:
Moving
Job change
Retirement
Travel
New Baby
Other
Select One:
0
1-3
3-5
5-7
7-9
9+
Select One:
1
2
3
4
5
Select One:
Yes
No
Select One:
Yes
No
Select One:
Yes
No
Select One:
Yes
No
Select One:
Own
Rent
Select One:
House
Apartment
Condo
Duplex
Mobile Home
Do any members of your household have pet-related allergies?
If you move, will your dog go with you?
Please review all your answers carefully and make sure all question are answered before clicking submit. Please allow at least 7 days from receipt of application for a response from Premier Pet Placement. If you have not received a call within 7 days, please contact the adoption line at
602-714-4168
Premier Pet Placement's main goal is to find the right home for the right dog--and to find the right dog for the right home. To help Premier Pet Placement do this, please fill out this application completely and accurately, with as much detail as possible. Note that providing a less than ideal answer to a question below doesn't necessarily mean that you will not be allowed to adopt a dog. The Adoption Representative who contacts you will use this application as a basis for dialogue and creative solutions.
Pet adopters can anticipate 10 or more years of joy with their dog. Because of this, adopters need the financial ability to care for their dog as needs arise, and need to provide stable and secure living arrangements. Students, though they may be responsible persons, often have little money, move frequently, and share homes with other students that come and go. As such they may not be able to offer sufficient long-term financial support and home stability for a pet.
Street Address:
City:
Home phone:
Work phone:
Cell phone:
Best way to reach you:
Best time to call you:
Email Address:
How long at this address:
Occupation:
Type of residence you occupy:
Do you own or rent:
If renting, do you have your landlord's permission and/or does your lease allow large dogs?
Are you willing to provide a copy of your lease agreement if requested?
Landlord's name:
Phone:
Number of adults in your household:
Describe the activity level of your household.
List the ages of any children in the household.
Hours adults are gone during the day (how long would the pet be alone?):
Does your family anticipate any major lifestyle changes in the next year? (select all that apply)
If you answered "other," please describe
What type of fence do you have?
If you answered "other," please explain your answer.
What is the height of the fence?
Do you own a cat or cats?
If yes, where do your cats live? (Please mark all that apply.)
List the types and ages of other animals currently in your household.
Please tell us about your previous animals, how long you had them, and what happened to them.
Describe briefly any negative experience you, your partner, or children have had with a dog.
If you have ever given up a pet (i.e. gave it away, relinquished to a shelter, etc), explain why.
Where will your dog be while you are gone during the day?
Who will be the primary caregiver(s) for you pet?
Are you prepared to provide a permanent home for a pet for the next 10 - 15 years?
Select One:
Yes
No
What access will the dog have to the yard?
Select One:
Have to let dog out
Dog door
Door is left open
Other
If your dog needs additional help in adjusting to home life, are you willing to seek
help in working through the problem?
Select One:
Yes
No
Would you be willing to learn how to provide behavior and obedience training for your new dog?
Select One:
Yes
No
What circumstances would justify giving up your dog (or any other dog?) (Please mark all that apply.)
Choose all that apply:
Biting
Growling
Barking
Chewing
Digging
Destructiveness
Marking
Housebreaking issues
Shyness
Moving
House Remodel
Having a child
Rough with children
Other
If other, please describe:
Vet business name:
Address:
Phone:
Are you interested in fostering a dog?
Select One:
Yes
No
Are you interested in fostering or adopting a special-needs dog?
Select One:
Yes
No
How did you find out about Premier Pet Placement?
Select One:
Internet Search
Meet 'n Greet
Friend / Acquaintance
Vet's Office
Pet Store
Other
If other, please describe:
I agree to keep my dog solely as a house pet, and agree never to use it for research / experiments.
Select One:
Yes
No
I agree to notify Premier Pet Placement immediately if my dog is lost or stolen.
Select One:
Yes
No
In the event that problems develop that prevent me from keeping this dog, I shall
contact Premier Pet Placement immediately.
Select One:
Yes
No
I will never give, sell, or otherwise surrender the dog to any other individual, rescue group, animal
control facility or shelter, or to any company or organization other than
Premier Pet Placement or its authorized representative.
Select One:
Yes
No
I agree to keep a collar bearing identification and the Premier Pet Placement tag on my dog.
Select One:
Yes
No
I agree to regularly vaccinate my dog and provide necessary flea / tick / heartworm
preventative, per my veterinarian's recommendations.
Select One:
Yes
No
I will allow PPP a phone interview and home visit prior to adoption.
Select One:
Yes
No
I am willing and able to provide the necessary funds to care for my pet's
daily needs, as well as any health or medical needs that may arise.
Select One:
Yes
No
I agree to inform Premier Pet Placement of any change of address or phone number
(for contact purposes in case my dog is ever lost or found).
Select One:
Yes
No
By typing my name in the following box, I certify that all the information contained in this application
is true and correct, and that I agree to abide by the agreements listed above, I also certify that all
members of the household are in total agreement with this adoption.
Agreements
Adopters Name:
Dr. Name:
Application for Adoption
Application for Adoption Form
Foster App
Donations
Print Adop App
Print Foster App
Contact Us
Home
Fosters Needed
