Pet parenthood is a serious responsibility. Each person or family who adopts a pet must understand and accept the responsibility and commitment that pet parenthood requires.
This application form is designed to help Project POOCH, Inc., make the best possible placement of a dog into your home. The adoption process may take some time since Project POOCH, Inc., is committed to doing everything possible to match the right dog with your circumstances. It is hoped that you will be provided with all the information and support necessary for a successful adoption. Each dog at Project POOCH, Inc., looks forward to a lifelong home.
In order to assist in the adoption process, please complete the following application carefully and thoroughly. If you have any questions, do not hesitate to call the above telephone number.
If you would prefer to print this form, complete it, and submit it by mail, click here.

Section 1: Applicant's Personal Information

Type *

Residence Details

Please tell us a bit about your living situation.

Time you have lived at your current address

Lifestyle Details

Qualities Applicant Seeks in a Dog

Look at the name in the field you just entered—is it the dog's name or your name? Sometimes your browser will try to autofill that field with your name and it makes it really confusing when we try to process your application.
Why do you wish to adopt a dog? (check all that apply) *
What type of dog do you wish to adopt? (Check all that apply) *

Other Household Pets

Pet #1
Pet #2
Pet #3
Pet #4
Please list all the pet(s) you have had in the last ten years, and include why the pet is no longer with you (died of old age, euthanized, rehomed, hit by car, etc ...
 Type of Pet & BreedReason Why No Longer With You

Pet Care & Facilities

Will this pet be *

Training & Behavior

Important Note:
Any dog can be unpredictable. All dogs respond differently to people. All dogs placed for adoption by Project POOCH, Inc., often have unknown histories that training may not overcome.
Young Children MUST by supervised while in the presence of a dog.
As a potential adopter I *
Application Certification

This certifies that the information contained in this application is true and complete. Through my signature below, I confirm that I agree to cooperate in the adoption process by providing medical care, training, and pet-related amenities as recommended by Project POOCH, Inc. Further, in the event that Project POOCH, Inc., places a dog in my household, I agree that before I sell or give up the dog, I will give Project POOCH, Inc., 15 days written notice at the above address to exercise its right of first refusal. *
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