The answers you give on this application will help us to find the best possible match between you and the dogs available through the Tillamook Animal Shelter, Inc. (TAS). This form cannot be processed with a phone number. Please fill out the form completely (*Denotes a required field to filled out).
Please return completed form to .
First & Last Name*:
Address*:
City, State*:
Zip Code*:
Email Address*:
Home Phone*:
Work Phone:
Occupation:
1. Dog or breed of interest?
2. Why this breed?
3. Previously owned this breed?
4. Sex of dog wanted?
5. Age of dog wanted?
6. Color preference?
7. Size preference?
8. Do you own or rent? If you rent, do you have the owners permission to keep this type of dog?
9. Do you live in an apartment?
10. How long at current residence? If less than 1 year list previous address and how long lived there.
11. Currently in your household:
12. Are there regular visitors (human or animal) with which your new dog must get along with?
13. Do you own other animals?
o Number of Dogs?
o Are dogs neutered/spayed?
o Breed, Sex and age of each dog:
o Number of Cats
o Are cats neutered/spayed?
o Other Animals?
14. Number of dogs owned in past 5 yrs:
15. Name of regular Veterinarian:
16. Name/phone & relationship of at least one personal reference:
17. Do you have a fenced Yard?
o If so, what is height and type.
o Does fencing completely enclose yard?
18. Do you have a separate kennel run?
o If so, List Height, size & type.
19. If no fenced yard or kennel, how will you handle the dogs exercise and toilet duties?
20. List all plans for this dog (Pet, obedience, agility, hunting, herding, Frisbee, fly ball, guard, other, etc.:
21. Describe where the dog will spend time during the day?
22. Describe where the dog will spend time during the night?
23. How many hours will the dog spend alone in an average day?
24. I have marked my preferences above, but would be willing to consider a suitable dog of a different Breed, Sex, Color, Size and/or Age (list all that apply):
25. Do you understand that TAS requires this dog be spayed/neutered?
26. Do you agree to license this dog?
27. Do you agree to give regular health care & grooming required for this breed?
28. Would you be willing to let a representative of TAS visit your home by appointment? If not, why?
29. Are you willing to give up 6 months for the dog to adjust?
30. Why would you get rid of a dog?
31. Do you agree to contact TAS if you do not want or can no longer keep this dog?
32. Are you over 18 years of age? If not, do you have your parents permission and support in getting this dog?
33. Do you understand that TAS has an adoption contract for you to sign?
34. Do you understand that TAS reserves the right to refuse an applicant for any reason?
35. TAS is a non-profit organization and in order to continue rescuing pets we must ask for an adoption fee so can help other pets in-need. Do you understand that TAS requires an adoption fee for each pet?
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