Date

MM

DD

YYYY

Name *

First Name

Last Name

Co-Applicant

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Cell Phone

(###)

###

####

Employers Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Applicants Work Phone

(###)

###

####

Co-Applicant Employer Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Co-Applicant work Phone

(###)

###

####

Do Infants or Toddlers Visit Your Home?

Yes

No

Tell Us About Your Home

Own Home

Lease Home

Rent Home

Is Your Residence

Rural

Suburban

City

Do You Live in a

House

Condo

Apartment

Do You Plan to Move?

Yes

No

Is there a yard for your dog?

Yes

No

Is there an enclosed fence?

Yes

No

If you don't have a secure yard for your dog, are you prepared to walk your dog at least three times a day on a secure leash?

Yes

No

Have you ever had a dog before?

Yes

No

Date of last vet visit?

MM

DD

YYYY

Spayed or Neutered?

Yes

No

Shots current?

Yes

No

Date of last vet visit?

MM

DD

YYYY

Spayed or Neutered?

Yes

No

Shots current?

Yes

No

Did they pass away?

Yes

No, still with us

Did you ever give a pet away to a:

Relative

Friend

Back to Breeder

Shelter/Rescue

No, I have never given a pet away

Have you ever had a pet that died in a accident or ran away and was never found?

Yes

No

Have you ever sold or given away a pet or your pet's offspring?

Yes

No

Vet Phone

(###)

###

####

Vet Business Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

We'd like to know you better so we can find your perfect match. Do you prefer (check all that apply)

Female Puppy (3 mos to 1 year old)

Male Puppy (3 mos to 1 year old)

Female Adult Dog (over 1 year)

Male Adult Dog (over 1 year)

Female Baby (under 3 mos)

Male Baby (under 3 mos)

Female Senior Dog (6+ years)

Male Senior Dog (6+ years)

Female Super Senior (10+ years)

Male Super Senior (10+ years)

Age/sex doesn't matter

Will you be willing to train your dog or go to training classes with him/her?

Yes

No

How did you hear about the Joshua Fund?

Internet Search for adoptable dogs

From The Joshua Fund Facebook Page

From Petfinder or other Pet Listing

From a Friend (please enter name below)

Have you, a member or your close and/or extended family, a friend, or neighbor, ever been accused/arrested/convicted of animal cruelty?

Yes

No

Under what circumstances would you re-home your dog?

Change in domestic status (marriage, divorce, new baby, new pet, etc.)

Moving

Training issues with dog

Dog grew too much

Dog barks too much

Neighbors complain

Dog has too much energy

Dog doesn't get along with other animals

Dog shows severe aggression toward humans

Dog shows aggression toward other animals

All of the above

None of the above

Are you willing to wait until The Joshua Fund finds a dog that will be the perfect fit for you and your family? You may apply now so we can check your references and we"ll keep you on file for six months.

Yes

No

Do you understand that the dogs we have usually have no history to go with them? They all come from high kill shelters and often have been surrendered by their owners, picked up as strays or have been abandoned. We try to evaluate their temperament but that is not always a true measure of how a dog will behave when they become a part of your family. Are you willing to to give a dog a chance at a new & loving life, no matter what it takes?

Yes

No

I will try my very best

I understand and want to apply

Yes

Full Name

By clicking the button below, you grant us permission to send you our e-mail newsletter. You may unsubscribe at any time. Thank you for applying to adopt a dog or puppy from The Joshua Fund! Please CLICK the SUBMIT button below.

First Name

Last Name

Please check this box to complete your application *

Do you confirm the information provided on this form is true and accurate?

Yes, I do