Adopt a Dog! Please fill out the following application completely and click on the Submit button. Your information will be sent via email to Animal House Rescue. If you have problems filling out or submitting the online application, please send us an email at doggiesaver@yahoo.com. Thank you!

• Dog Name:
• Name: *
• Address: *
• City: *
• State: * AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
• Zip: *
• Phone: *
• Cell: *
• Email: *
• Adults in Household and their ages:
• Children in Household and their ages:
• How did you hear about Animal House Rescue?:
• Is this your first dog?
• Why do you want to adopt this dog?
• Why do you want this breed?
• Who made the decision to adopt this dog?
• On a scale of 1 (quiet) to 5 (high energy),what activity level are you looking for? 1 (quiet) 2345 (high energy)
• Where will your dog spend most of his/her time?YardGarageCrateConfined to a certain area of the houseFree run of the houseIndoors with a dog door
• Do you realize that there is an adjustment period for housebreaking when entering a new home? YesNoUnsure
• What type of housetraining methods will you use?
• Do any family members have allergies, and if yes please explain.
• Do you live in a: *HouseApartmentMobile Home
• Do you:rentown
• What kind of area do you live in?SuburbCountryCity
• Do you have a fenced yard and if yes what type of fence?Chain LinkPrivacyInvisibleOtherNone
• Do we have permission to contact your vet and references?YesNo
• Do you agree to a home visit by one of our representatives?YesNo
• If you live out of state, please list the name and number of the humane society in your area.
• Where will your dog sleep at night?
• Do you plan to use a crate for your dog to stay in when you are not at home? Please explain why or why not.
• Do you plan on having your dog mainly indoors or outdoors, and please explain.
• What is your definition of disciplining a dog?
• Please list all current pets, including - type of pet, breed, age, sex, spayed/neutered status, indoors or outdoors pet.
• If you have current pets, what type of heartworm prevention is your dog/cat on?
• If you have current pets, what type of flea control do you use?
• If you have current pets, when you are not at home, where does your pet(s) stay?YardGarageCrateConfined to a certain area of the houseFree run of the houseIndoors with a dog door
• If you have current pets, do you consider any of them to be aggressive towards people or other animals? If yes, please explain. *
• Have you ever given a pet away, and if yes please explain your reasons
• Please list the Names, Addresses and Phone Numbers of 3 References.
  (Important: At least 2 of these can NOT be relatives.)
  Reference 1 *
• Reference 2 *
• Reference 3 *