960 N. Flag Chapel Rd.
Jackson, MS 39209
(601) 922-7575

Dog Applications


INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED

Pet Interested in:

Breed:

Today's Date:

(Person applying MUST be 21 yrs of age).

Name:

Phone:(Home)

Phone:(Work)

Age:

Email:
Phone:(Cell)self

Address:

City: State:
Zip:
Name of spouse/significant other/roommate: Phone:(Cell)spouse
Occupation #1: Place of Employment:

Occupation #2: Spouse's Place of Employment:

If this relationship were to change, whom would the pet remain with?

Do you have children? Yes No

Age(s):

Do they live with you? Yes No

Have they been around dogs? Yes No

Reasons for adopting?

Companion for you
Companion for your dog
Spouse
Children
Gift (for whom?)
Other

What qualities you are looking for in a dog?

What, if any, concerns do you have about adopting?

HOME INFORMATION

Type of Dwelling:

The dog will be:

House

Indoor only

Mobile Home

Indoor/Outdoor

Apt

Outdoor only

Garage
Balcony

Condo

Farm/Home with acreage Years at residence?

OWN

RENT


What outside space is available for the dog(s)?

No Fence/Open Space to Run

No Fence/No Yard

Fenced/Enclosed yard = Height

Type of Fencing?

Locks on gates? Yes No

Outside Tie Out

Outside Dog Run

Where will the dog sleep?

Area(s) dog is NOT allowed?

PAST/PRESENT PET HISTORY (Past 10 years only)

Current pets in household: Dogs Cats Other -

(Please describe PAST and PRESENT animals)

Breed

Age of Pet

Sex

Spayed/neutered?
Yes/No

Age Pet Acquired?

Still Own?

Reason for no longer owning?

Are your pets vaccinated? Yes No

Date of last vaccinations:

Current or last veterinarian:
Name:

Address:

Phone:

May CARA contact your vet? Yes No

How many hours per day on average will your dog be alone? O-4 4-6 6-8 8-1O 1O-12 12+

What provisions do you have to let the dog(s) out during the day while you are gone?

Do you have a friend or relative who would care for the dog(s) if you became incapable of caring for him/her for an extended period of time? Yes No

Please provide: Name:

Address:

Phone number:

CARA reserves the right to approve this individual, with no bias, for the ultimate protection of the dog(s).

Please list 3 character references:

Name:

Name: Name:

Address:

Address: Address:
City: City: City:
State:
State: State:
Zip:
Zip: Zip:
Phone:
Phone: Phone:

Relation:

Relation: Relation:
GENERAL PET QUESTIONS

HOW do you plan on housebreaking your new dog?

(Please understand that even dogs that are housebroken will go through an adjustment period)

Under what conditions would you NOT keep your new pet?

New baby

Dog(s)/Cat(s)

Grew too big

Allergy

Move to a place that doesn't allow pets

Move out of state

Too much hair

Chewing

Housetraining problem

Pets didn't get along

Not obedient

Wouldn't give up for any reason

ALL DOGS MUST BE RETURNED TO CARA SHOULD YOU NOT BE ABLE KEEP THEM!

If the dog(s) become destructive, what would you do?

Do you travel frequently? Yes No

Where will your dog(s) stay when you are on vacation?

Please briefly describe your lifestyle: (active, social, homebodies, etc)

How did you hear about CARA?

Web site

Referred by Someone

Media
Other

ADOPTIONS MAY REQUIRE A HOME CHECK AND/OR DELIVERY OF DOG(S).

I CONSENT TO THIS IN THE EVENT MY APPLICATION IS APPROVED:Yes No

Signature: Required on pick up

Providing false information will result in the nullification of this application.