Please Fill Out Our Adoption Application Step 1 of 6 16% Contact InformationApplicant Name* First Last Co Applicant Name First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Work PhoneCell PhoneOccupationEmail* Greyhound InformationWill this be your first pet?* Yes No No Answer How did you find out about American Greyhound?What characteristics do you desire in a Greyhound?If you are interested in a particular dog, please indicate dogs name here. Are you willing to crate your dog when it is alone?* Yes No No Answer Are there stairs in your home?* Yes No No Answer Are you willing and able to walk or let your dog outside to relieve him/herself 4 to 6 times a day?* Yes No No Answer Would you be willing to consider adopting an injured dog?* Yes No No Answer Do you agree to keep a collar bearing identification on your Greyhound at all times?* Yes No No Answer Do you agree to notify American Greyhound if for any reason you find that you cannot keep your Greyhound and further agree that you will NOT give away or sell the Greyhound without American Greyhound consent?* Yes No No Answer EnviromentDo you intend to keep your dog in the house?* Yes No No Answer Is your area fenced?* Yes No No Answer Do you live in a?* House Apartment Mobile Home Condominium No Answer Do You Rent?* Yes No No Answer Landlord's Phone Number*Do you Have Other Pets?* None Dog Cat Other List Other Pets*Are your present pets on heart worm preventative?* Yes No No Answer What type of pets did you previously own?* None Dog Cat Other List Other Owned Pets*What Happened To Them?*What was the name of your veterinarian then? First Last Veterinarian PhoneHave you ever given a pet to a Humane Society or Animal Control Facility?* Yes No No Answer Do you currently have a veterinarian?* Yes No No Answer Your FamilyNumber of adults in the household and the hours they are home:*Number of children in the household and their ages:*Are there children who visit frequently ie: grandchildren, baby sitting? If so, what are the ages and how often are they in the home?*Are all members of the household in TOTAL AGREEMENT about adopting a Greyhound?* Yes No No Answer ReferencesIf you do not have a vet as a reference, please list two additional references. (only one may be a relative). It is mandatory that you include references. Failure to do so will delay your application from being processed in a timely manner.Reference #1*Please List Name, Address, and Phone NumberReference #2*Please List Name, Address, and Phone NumberReference #3Please List Name, Address, and Phone NumberReference #4Please List Name, Address, and Phone Number AgreementsAre you willing to accept immediate and full responsibility for the ownership of your Greyhound, including all health care costs and necessary burdens and responsibilities of owning a pet?* Yes No No Answer Do you agree to give your pet heart worm preventative?* Yes No No Answer If for any reason you are unable to continue to care for your greyhound, do you agree to return to American Greyhound?* Yes No No Answer For what reason, if any, would you return this animal? Check any that apply Chewing Nipping Jumping Allergies Barking Aggressiveness Moving Loss of Interest Not Enough Time Other Are you willing to provide American Greyhound with follow up reports?* Yes No No Answer I give permission to (veterinarian office listed below) to release veterinarian information about my pets to representatives of American Greyhound.Section BreakOur adoption fees are as follows: $300 for Adult racers/lurchers $400 for TGIE (prison dog rescue) $500 for Galgos Dog Specific fee for Special Needs (older dogs, dogs with special health related issues) This fee includes spay/neutering, vaccinations, teeth cleaning, micro chipping and checking for heart worm and other parasites. We cannot guarantee the dog will be parasite free and suggest the new owner make an appointment with their veterinarian to have the dog thoroughly examined at the owners expense. The adoption fee is non-refundable. We reserve the right to refuse or deny any application.I hereby certify that all the information contained on this adoption application is true and correct. I understand that completing this application does not guarantee an adoption.* Yes No Δ
