Dog Adoption form

Name:  

Name of Spouse

Address:  

City: 

State:    Zip: 

 Email Address:   Required

 Home Phone : 

 Work Phone : 

How long have you been a resident of Gaston County?


How long have you lived at your current address?

Was there a particular animal on the available pets page you're interested in?  If so, which one?

Type of dog desired:

Age of dog desired:

Type of coat:

Color:

Dog will live: 
Indoors         Outdoors 
  Mostly Indoors       Mostly Outdoors

Reason for adopting a dog/puppy:


Type of Residence: 
House    Apt    Condo   Mobile Home

Answer YES or NO if applicable

If rental: Are dogs allowed?
Deposit Required?
Complex Name:
Manager/Landlord: Phone #:

If children are living at home, please list ages:

How will dog be contained?

Fenced Yard Runner Pen Chain Click here to choose one if applicable

Where will dog spend it's nights? 
Inside    Outside

Are all adults in household aware you plan to adopt a pet? Yes      No

Do you currently have pets in the home? 
Yes    No
If so, list types, breeds, sex:

Have these pets been spayed/neutered?

How many pets have you had in the last 5 years?

Dogs or cats?

If so, what happened to these pets?

What veterinary clinic do you go to?