Which dog are you interested in?
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If you are direct adopting off of a transport the dog may not be microchipped. We do require you to get the dog microchipped within 7 days with Grubby Paws listed as the secondary contact. If this is not completed in 7 days Grubby Paws reserves the right to revoke ownership of the dog. Do you agree to provide proof within 7 days?
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Yes
No
Applicant Name
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First Name
Last Name
Age
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Email
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Phone
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(###)
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Driver's License #
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
How long have you lived there?
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Employer
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How long have you worked there?
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How many days per week do you work?
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How many hours per day?
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Do you go to a worksite or work from home?
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Worksite
Work from home
If you work from home, is this arrangement due to the COVID pandemic?
yes
no
If yes, please explain:
Provide two references that are not members of your immediate family:
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Reference #1:
First Name
Last Name
Years known
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Relationship
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Phone Number
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(###)
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Reference #2
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First Name
Last Name
Years known
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Relationship
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Phone
(###)
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What type of home do you live in?
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House
Apartment/Condo
Townhouse/Duplex
Other
If other, please explain:
Who shares your household?
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Spouse/Life Partner
Boyfriend/Girlfriend
Roommate(s)
Other
If you selected roommates, how many?
If you selected other, please explain:
Are there children in the home?
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yes
no
If yes, how many?
How old?
Your home is:
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Owned by you
Owned by your spouse or partner
Owned by both you and your spouse/partner
Owned by someone else in the house
Rented directly from the owner or through a management company
Rented as a part of a group of roommates
Other
If other, please explain:
If renting, is your name on the lease?
Option 1
Option 2
If no, please explain:
If renting, do you have your landlord's permission to have a dog?
yes
no
Landlord's Name
First Name
Last Name
Landlord's Phone
(###)
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Does anyone in your home have an allergy to dogs that you are aware of?
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yes
no
If yes, please explain:
What rooms/areas are off limits for the dog?
I currently do not have a yard (skip to the next section)
What outside areas are available to the dog? (check all that apply)
Front yard
Back yard
Enclosed patio
Dog house
Garage
Other
If other, please explain
Do you have a swimming pool?
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Yes
No
If yes, how will you protect the dog from the swimming pool until they learn boundaries?
Do you have a doggie door?
yes
no
Is your yard shared with neighbors?
yes
no
Is your yard fenced?
yes
no
What type of fence?
Fence height:
Highest point:
Lowest point:
Have you recently inspected your fences?
yes
no
Are they in good condition with no holes or loose points?
yes
no
If your dog will have free access to a fenced yard, where is it located?
Front yard
Back yard
Side yard
Which of the following is used to secure your gate?
Latch
Padlock
Keyed lock
We do not lock our gate
Other
If you do not lock your gate, or you selected 'other,' please explain:
If your gate does not have a lock, are you willing to install one?
yes
no
Who has access to your yard? (check all that apply)
Gardener
Pool Maintenance
Utility
Postal Worker
House Keeper
Delivery
Neighbor
Other
If yes, where is the dog kept while they are working?
Do you trust your workers not to let the dog out?
Yes
No
Is someone home during the day?
Yes
No
Where will your dog spend most of his/her day when you are home?
Indoors
Yard
Indoor/Outdoor
Garage
Enclosed patio
Other
How many hours will your dog be alone each day?
Where will the dog stay when he/she is home alone?
When will the dog be inside?
When will the dog be outside?
Where will the dog sleep at night?
If you go away overnight (or longer), what are your plans to care for the dog?
How will you exercise the dog and how often?
How would you describe your dog owning experience?
I have had dogs of my own as an adult
I grew up with dogs but have not had my own as an adult
I have never had one or have limited experience with dogs
Other
If other, please explain
How many dogs have you owned in the past 5 years and what happened to them?
Do you currently have pets?
Yes
No
If yes, please provide the following information for each animal:
Name, Type, Breed, Gender, Age, Spay/Neutered? If not, why?
How long have you had each pet?
How do you feel your current pets will adjust to a new dog in the house?
What type of training do you plan to do with your new dog?
Have you had experience with behavioral or medical issues with your previous or current pets: If yes, please describe:
Have you or would you be willing to enroll your dog(s) in obedience classes:
Yes
No
Only if we had problems
How would you discipline your dog if he/she misbehaved and/or chewed household items:
What method do you intend to use to housetrain your dog: (check all that apply)
Rub nose in offending spot
Crate training
Take out every couple of hours
Consult a professional
Other
CheckboxShare your reasons for wanting a dog: (check all that apply)
Family pet
Companion
Gift for someone else
Child's companion
Protection/guard dog
Companion for another pet
Other
If other, please explain:
In which of the following situations might you allow your dog off leash:
Public park
Hike
Backyard
Dog Park
Neighborhood walk
Front yard
Beach
Other
Pets are an investment of your time and money. Can you afford to provide medical care, grooming, proper diet, shelter, and exercise for your new dog:
Yes
No
Explain:
What is your monthly budget for your dog:
Who will have financial responsibility for the dog:
If your dog went missing, what would you do:
Would you like food recommendations?
Yes, please
No
Are you able to make a long-term commitment to care for your dog for its entire life span, which could be as long as 15 years or more:
Yes
No
Other concerns:
Your veterinarian name and phone:
If you move, what will you do with your dog:
Which of the following reasons might force you to give up your dog: (Check all that apply):
Excessive barking/neighbor complaints
Aggressive on leash
Destructive chewing
Biting/aggression
Digging
Divorce/separation
Allergies
Shedding/dirty
Not trainable
Poor watchdog
Moving/relocating
House training problems
Financial problems
Growling/nipping at guests
Excessive vet bills/chronic illness
Having a baby
Nips or bites children
New spouse/partner does not likes dogs
Pets are not getting along
None of the above
Does everyone in the household actively want to adopt a dog? If no, explain:
If you have a training issue that is beyond your ability to handle on your own, what will you do? Are you willing to hire a trainer?
What one or two things are you most concerned about when adopting a new dog?
Have you ever re-homed a pet, and if so when, and why?
Any other comments you would like to include about why you would like to adopt a dog:
Is there anything else you would like to share with us?
Please read each statement and check the box in agreement
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I/WE understand that a home visit may be required prior to final placement and that a home visit does not guarantee placement of a dog.
I/WE agree to provide my/our own collar, leash and a personal ID tag at the time of completing the adoption contract.
I/WE agree to contact Grubby Paws Rescue (GPR) if I/WE am/are no longer able to keep the dog for any reason or upon GPR approval, assist with finding a new owner.
I/WE agree, if requested, to submit a home video consisting of short videos (easier to receive) of the public rooms (kitchen, living room), my/our secure fence line, and my/our fenced yard which may be an option in lieu of an in-person home check.
I/WE agree to microchip and/or have any vaccination boosters administered within one week of the adoption date. Failure on my/our part to do will result in Grubby Paws Rescue removing the dog from the home.
By providing my/our signature(s) below and submitting this application, I/WE hereby certify I/We have provided accurate information to the best of my/our knowledge.
I/WE understand that any false information will most likely result in denial of my/our application. I/WE authorize the verification of all information provided to confirm accuracy, which included but is not limited to current and previous vet records, home ownership, rental agreements and public records.
I/WE understand that the submittal of this application does not guarantee adoption of a dog. I/WE understand Grubby Paws Rescue can receive multiple applications for the same dog and must make the best decision to match the dog to the most appropriate adopter based on the dog’s needs, behaviors and happiness.
I/WE understand meeting with the dog is one of the steps to potential adoption but it is not a guarantee I/WE will be selected. However, meeting with Grubby Paws Rescue does give them the opportunity to get to know me/us and learn about what placement, if any will work best for all parties.