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Adoption form

Kenai’s House Inc is a non-profit, animal welfare organization dedicated to the rescue and placement of stray, neglected and abused animals.

Kenai’s House Inc is completely funded through fundraising efforts and public donations.

All of our pets are cared for by foster homes and receive complete medical care, which includes worming, vaccinations, spaying/neutering and microchipping prior to their adoption.

This questionnaire is designed to help Kenai’s House Inc and yourself determine if a specific dog is the right one for you and your household.

ADOPTION APPLICANT INFORMATION

Adoptee

First Name *

Last Name *

Email *

Phone *

Age *

Address

Street Address

City

State

Country

Postal Code

Employer (optional)

Character Reference Name *

Character Reference Phone *

Are all members of your household in agreement with this adoption? *

Yes

No

Don't Know

Who Will be the pet’s primary care-giver? *

Does your landlord allow dogs?

Yes

No

Don't know

Please provide more information about restrictions

Do you have a pool or jacuzzi? *

Yes

No

If so, is it fenced off? *

Yes

No

Do you have a fully fenced yard? *

Yes

No

Height and type of fence

Do you have any of the following? *

Underground fence

Kennel

Dog run

None

How Many children are in your household? *

If so, what are their ages?

Have your children been around animals before?

Yes

No

Does anyone in your home have allergies to dogs or have asthma? *

Yes, someone is allergic to dogs

No one is allergic to dogs

Yes, someone has asthma

No one has asthma

Current/Previous Pet information

List any pets you own or have owned in the past five years, and their ages *

How Many of these pets are spayed/neutered? *

Where are these animals now? *

Have you adopted from an animal welfare group before? *

Yes

No

If yes, what group?

Have you given up a pet? *

Yes

No

If yes, what were the circumstances?

Do you have a 24 hour emergency vet near you? *

Yes

No

If yes, list contact info here

Please provide the name and phone number of your current and/or previous veterinarian or clinic: *

New Pet information

What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato) *

Are you aware of crate training? *

Yes

No

Have you ever house-broken a dog or puppy before? *

Yes

No

If the dog has an "accident" in your home, what type of correction do you plan to use? *

How many hours each day will your new pet be home alone? *

Where will your new pet sleep at night? *

When you travel, where will your new pet go? *

How will you supervise the dog's outdoor activity? *

Where will your new dog stay when nobody is home? *

What length of time will you allow your new pet to adjust to his new home? *

Are you willing to work through your new pet's issues, if any? *

Yes

No

Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior? *

Yes

No

Do you understand that a dog can be an 18 year commitment, and can cost $300 - $500 per year to care for? *

Yes

No

Do you plan to continue dog training at home? *

Yes

No

Don't Know

If yes, Please describe how:

Are you aware that a large breed dog takes about two years to mature? Is this something you're prepared for? *

Yes

No

What circumstances would lead you to give up your new dog? *

If you had to give up your dog, what would you do with him/her? *

I understand that I assume full responsibility for the welfare of this pet from the date of adoption. *

Yes

No

DISCLAIMER: By typing your full name below and submitting your signature in the next field, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application and are hereby acknowledging that all the information provided within this application on your behalf is absolutely true and correct to your best knowledge.

Please provide your signature here, it must match your full name given to us earlier

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EIN #88-3998252