Dog Application

Which Dog(s) Would You Like To Meet? - Up to 5 *

In order to be considered for an adoption you must:

Have the knowledge and consent of all adults living in your household
Have a valid photo I.D. present

Please fill out the below:

Applicant's Name *

First

Last

Name of Spouse/Roommate(s) *

First

Last

Please list ages of people in the home *

If anyone in the household is allergic to animals, please say who and to what *

Other: Please explain here *

Where will the dog be when you're not home? *

How many hours a day will the dog be left alone? *

Other: Please explain here *

How much time are you willing to spend helping this dog adjust to your home and lifestyle? *

Under what circumstances would you not keep this dog? *

What would you do if the dog was destructive? (Chewing, Barking, House Soiling) *

What do you feel is aggressive behavior? *

What would you do if this behavior occurred? *

How do you plan to house train your dog? *

Do you own a pet now? *

Yes No

Have you had pets in the past? (If yes, please list below) *

Yes No

Who is/was your Veterinarian for the above animal(s)?

Please read and select "Agreed" at the bottom.
I understand that adopting an animal is a financial commitment and may incur costs associated with feeding, licensing, and providing veterinary care for the animal.

Please read and select "Agreed" at the bottom.
I understand that a dog may live 15 years or more.

By agreeing below, I certify that the information I have given is true and that I recognize that any misrepresentation of the facts may result in my losing the privilege of adoption a pet. I understand that an incomplete application will not be processed. I authorize investigation of all statements on this application. I understand that this application is the property of the Humane Society of Southwest Missouri and will not be returned to me.

Please Fill Out The Below To Apply

Humane Society of Southwest Missouri