Adoption Application – Online Form

Due to Massachusetts State Regulations we are unable to adopt to residents of Massachusetts at this time. We apologize for any inconvenience.

How did you learn about Peppertree?

Adoption Applicant(s)

Name*

First Last

Home Phone*

Work/Mobile Phone

Email*

Employer

Position

Additional Applicant?

Name*

First Last

Home Phone

Work/Mobile Phone

Email

Employer

Position

# of Adults in home:

Specific ages of adults:

Any children in home?

# of Children in home:

Specific ages of children:

Do small children, under 8, visit frequently:

Residence

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Type of setting:

Type of residence:

Own or rent:

Landlord's Name

Landlord's Phone

Do you have a fenced yard:

Fence Type:

If "Other", please explain briefly:

Height (lowest point):

Care and Maintenance

# of hours dog will be alone (longest):

Are you willing to crate your dog in the beginning (if needed)?

Where will the dog be when you are not home during the day?

At night?

Have you ever participated in obedience training with a dog?

Do you plan on training with this dog?

References

Reference #1

Name

Reference #1 Phone

Reference #2

Name

Reference #2 Phone

Veterinarian we should call for a reference:*

Phone

You must contact your vet and give permission to release records to Peppertree before your application can be considered.

Family Pets

Do you currently have any other pets?

Please select all types of pets you currently have:

Dogs
Cats
Small Animals
Other

If "Small Animals" or "Other", please briefly explain:

*please note we require resident cats and/or dogs to be altered or that you provide a veterinary waiver as to why pet has not been altered

Current Pets (max 10)

Name	Type of Animal	Breed	Age	Sex	Spayed or Neutered?	Characteristics

Have you had any pets in the last 10 years (not including current pets)?

Past Pets (max 5)

Name	Type of Animal	Breed	Age	Spayed or Neutered?	Where Are They Now?

Dog Preferences

Are you interested in specific dog(s) on the Peppertree website?

Dog you are interested in

Activity level you want:

Breeds you like:

Gender

Must your dog be purebred?

Age preference (check all that apply):

Puppy
Young (6mos-2yrs)
Adult (2-7yrs)
Senior (7+yrs)

Size preference (check all that apply):

Toy
Small
Medium
Large
Giant

If specific request:

Check if you want a dog who is good with...

Children
Other dogs
Cats

Other traits/characteristics that are important to you:

Any additional information or comments:

May we share your application with other rescues that may have a dog that fits your preference?

A donation of $5.00 to help with processing and phone costs would be greatly appreciated. Please send a check or donate via PayPal.

The adoption fee is $250 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.

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. I GIVE PEPPERTREE RESCUE, INC. MY CONSENT TO BE CONTACTED IN REGARDS TO AVAILABLE DOGS INCLUDING THE ADOPTION EVENT ANNOUNCEMENTS, WHICH I MAY OPT OUT OF AT ANY TIME.

Name

This field is for validation purposes and should be left unchanged.