Select Pet Name
Alex (Dog - D21100)
Aya (Dog - D21227)
Bruce (Dog - D2020069)
Chief (Dog - D21002)
Cookie (Dog - D21235)
Ginger (Dog - D21251)
Gracie (Dog - D21247)
Hattie (Dog - D21081)
Hooch (Dog - D21213)
Lucy (Dog - D21254)
Maddie (Dog - D21250)
Marsha (Dog - D21135)
Molly (Dog - D21240)
Penelope (Dog - D21233)
Rex (Dog - D21249)
Rocko (Dog - D21246)
Sadie (Dog - D21257)
Sage (Dog - D21252)
Sally (Dog - D21255)
Sam (Dog - D21258)
Sue (Dog - D21256)
Winston (Dog - D21260)
Type pet name(s) of others interested in.
Applicant First Name
Applicant Last Name
Employer's Phone Number
How long employed?
Spouse's Phone Number
If approved to adopt, will you be able to bring the dog home within 2 weeks after approval?
What age, size, sex, and energy level are you interested in?
Is this dog a gift for someone?
Why do you want to adopt a dog?
Your home is:
Approximate square footage of home
Do you own the property?
Do you live with relatives?
If you are renting, please provide Landlord's name and phone number for verification
If your landlord allows dogs, is there a weight/size/breed restriction?
What are their restrictions?
Approximate yard size?
Is the yard enclosed by a fence?
If so, height, length, and type of fence:
Approximate square footage of fenced-in area:
How does the dog have access to the fence in portion (i.e. dog door, back door, sliding glass door)?
How will you train your dog?
What will you do if your dog has a bathroom accident in the house?
Will you crate and for how long?
Where will your dog sleep at night?
How long will your dog be alone each day?
Where will your dog stay when they are alone?
What activities will you do with your dog?
Do you have someone that will help if you are adopting a puppy?
May we speak with them also?
How much time each day are you committed to walking and playing with your dog?
Will you be willing to take your dog to obedience classes?
What would make you re-home your dog?
Where will your dog stay when you are on a trip?
Who will take care of your dog if you are hospitalized or die?
Does anyone in the homes have allergies to animals?
Has everyone in the family agreed to adopt an animal?
What is your own level of activity?
Constantly on the Run
Pup's living situation (check all that apply) *
Pup will be house pet and living inside with family
Pup will live in basement or garage
Pup will live outdoors
Guard Dog for Business
Guard Dog for Residence
Please specify other living situations
How will you exercise the pup? (Check all that apply) *
Leash walks every day
Will have cable or pup run in the yard
Will be free to run in fenced yard
Will have supervised access to unfenced yard
Will be free to roam around (Off leash and unsupervised in unfenced area)
Will bring to a dog-park (Public area where pups can run and play together off-leash)
Standard medical care costs from $150-$300 per year. Emergency care can cost hundreds, even thousands, of dollars. Are you willing to provide standard and emergency care for this pet? *
How would you rate your pet experience? *
First time pet owner
Have you ever housetrained before? If so, what method did you use?
When home alone, the pup will be (check all that apply)
Outside Trolley Cable
Tied Up With Chain
If the pup will be in other places while home alone, please specify
Number of adults in home:
Number of adults home during the day:
Number of children in home:
Age(s) of children in home:
Please list all the pets you've had in the past 10 years:
Do you still own these pets? If not, why?
Please list age and gender of pets currently in household:
Are (were) your pets spayed/neutered?
Are (were) your pets current on vaccinations?
Are (were) your pets on heartworm preventative? If no, why not? If yes, what kind and where do you purchase it?
Please list 3 references, along with your relationship to the reference, AND a vet reference (name & phone #): Vet reference (must have seen your pet MULTIPLE TIMES, as well as seen all pets listed within the past 10 years; multiple vets are accepted):
By applying for the adoption of an animal from Beebe Animal Control, you hereby give your veterinarian(s) and other references permission to disclose information to Beebe Animal Control. To aid in this process, please contact your vet to let them know that we will be contacting them.