| How did you learn about Peppertree? |
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| Adoption Applicant(s) |
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1. Last Name:
First Name:
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| Work/Cell Phone: |
| Employer: |
| Position: |
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2. Last Name:
First Name:
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| Work/Cell Phone: |
| Employer: |
| Position: |
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Home Phone:
Email address:
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# of Adults in home:
Specific ages of adults:
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# of Children in home:
Specific ages of children:
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Do small children, under 8, visit frequently:
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| Residence |
| Street Address:
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City:
State:
Zip Code:
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Type of setting:
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Is your residence a:
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Own or rent:
If rent, landlord's name & phone:
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Do you have a fenced yard:
Height (lowest point):
Fence Type:
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| Care and Maintenance |
| # of hours dog will be alone (longest): |
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Are you willing to crate your dog in the beginning?:
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Where will the dog be when you are not home during the day?: |
| At night?: |
How will the dog be exercised:
Fenced area
Walks on leash
Jogging, running
Off leash, unfenced area
Other
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Have you ever participated in obedience training with a dog:
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Do you plan on training with this dog:
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| References |
1. Name:
Phone (or address):
2. Name:
Phone (or address):
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Veterinarian you intend to use:
Phone:
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| Family Pets |
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Do you currently have any other pets:
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Have you had any pets in the last 10 years (not including those listed above):
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| Dog Preferences |
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Are you interested in specific dog(s) on the Peppertree website?
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| Activity level you want:
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| Breeds you like: |
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Gender:
Must your dog be purebred:
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Age (check all that apply):
Any
Puppy
Young (6 months-2 years)
Adult (3-6 years)
Senior (7+ years)
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Size (check any you might be interested in):
Toy
Small
Medium
Large
Giant
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| If specific request: |
| Color: |
| Coat: |
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Check if you want a dog who:
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Will jog with you
Travels well
Can eventually go off leash
Won't need obedience training
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Is good with ... children
other dogs
cats
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| Other traits/characteristics that are important to you: |
| Any additional information or comments: |
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May we share your application with other rescues that may have a dog that fits your preference?
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Security Image:  |
| Security Image Text (above): |
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| If you are out of the immediate Capital District area and cannot attend a Peppertree Clinic in the Albany, NY area, please send a home visit report from a local rescue group. |
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| A donation of $5.00 to help with processing and phone costs would be greatly appreciated. Please send a check or donate via PayPal. |
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| AS OF JUNE 1, 2013, the adoption fee is $200 for most puppies and dogs. Different fees may apply in exceptional circumstances such as medical problems or extreme age. Adopter will pay for spay/neuter of a dog less than 6 months old. |
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| BY CLICKING SUBMIT, I ACKNOWLEDGE THAT ALL THE INFORMATION CONTAINED IN THIS FORM IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT ANY MISREPRESENTATIONS OF FACT MAY RESULT IN THE REMOVAL OF THE ADOPTED DOG FROM MY HOME BY PEPPERTREE. |
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| Please wait while we process your request... |
