TUBU Animal Rescue Dog Application

TUBU DOG ADOPTION APPLICATION

Name:
Date of birth
Street Address
City
State
Zip
Home Phone
Work Phone
Email Address:
Type of residence
Do you rent or own	Rent Own
If renting, name and phone number of landlord.
How many adults live in your household?
How many children?
Ages of children.
List 3 personal references.
Do you have a regular veterinarian?	Yes No
Doctors name, clinic name, and phone number.
If you don't have a regular vet, who will you take your pet to?
Do you presently have pets?	Yes No
Are your present pets spayed or neutered?	Yes No
Are they current on their vaccinations	Yes No
Are your dogs tested for heartworm and given preventative?	Yes No
If you answered no to any of the 3 questions above, please explain.
What pets have you owned in the past?
How many hours a day will your dog be alone?
Do you plan to crate your dog?	Yes No
Where will the dog be kept at night?
Where will the dog be kept when you are away?
What dog are you interested in?

By submitting this document, you are stating that all the information given herein is accurate
and complete and that you are hereby giving your consent for TUBU ANIMAL RESCUE INC. to verify any and all
information contained herein. The completion of this form does not entitle you to any
guarantees or rights.