Application for Adoption and Foster Home/Volunteer Program

Please fill out this application completely before submitting. 
REQUIRED FIELDS IN RED!
 If you have any questions, you may call us at (786) 229-9002.

 080308

Interest:  Adoption Foster Home/Volunteer    Dog's Name:

 
APPLICANTS
Applicant Full Name:
Co-Applicant Full Name:
Relationship to Applicant:
Address:
City:

State:  

 

Zip:

  
Phone1:

Phone2:
Email1:

Email2:
Employer (Applicant):

Phone:

   Position:  
Employer (Co-Applicant):

Phone:

   Position:  
HOUSEHOLD
List adults that live in the household other than Applicants:
1. Relation:   Age:  
2. Relation:   Age:  
3. Relation:   Age:  
4. Relation:   Age:  

List children that live in the household other than Applicants:
1. Relation:   Age:  
2. Relation:   Age:  
3. Relation:   Age:  
4. Relation:   Age:  

DOG PREFERENCE
Sex:

Male  Female  No Preference
Energy Level: High  Medium  Coach Potato  No Preference
Age: Under 1 Year  1-3 Years  3-5 Years  Over 5 Years  No Preference
Color: Chocolate  Yellow  Black  No Preference