Adoptable Dogs

Name

Email Address

Address Line 1

Zip Code

City

Address Line 2

Phone Number

State

Are you an active, reserve, seperated, or retired member of the U.S. military? Are you an active, reserve, seperated, or retired member of the U.S. military? Yes No

If you're interested in more than one dog, please list his/her name

Name of the dog you are interested in

How many hours will the dog be left at home alone (without humans)?

Are there any animals currently living in the home? Are there any animals currently living in the home? Yes No

If you do have pets living with you, please list type (dog, cats, etc), breed, and whether they are neutered/spayed.

How many children live in your home?

Please provide ages of any children living in the home.

How will the dog get exercise? How will the dog get exercise? Access to Yard Walked 3-4x a day Walked 1-2x a day Other

For the purpose of providing support, New Leash asks for bi-weekly updates on the dog for 3 months following the effective adoption date. Will adopter be able to commit? For the purpose of providing support, New Leash asks for bi-weekly updates on the dog for 3 months following the effective adoption date. Will adopter be able to commit? Yes No

How did you hear about New Leash on Life USA? How did you hear about New Leash on Life USA? Social Media News Word of Mouth Connection with organization Other

I understand that New Leash on Life USA will conduct adoption meets in the order that applications are received, and that the order in which applications are received does not provide me or deem me approved; home visit, a dog and/or cat meet prior to approving an adoption will be conducted, and New Leash may require to conduct multiple meets prior to finalizing a decision. I certify that the above information is true and understand that false information may result in nullifying this adoption. I understand that New Leash on Life USA will conduct adoption meets in the order that applications are received, and that the order in which applications are received does not provide me or deem me approved; home visit, a dog and/or cat meet prior to approving an adoption will be conducted, and New Leash may require to conduct multiple meets prior to finalizing a decision. I certify that the above information is true and understand that false information may result in nullifying this adoption. Yes No

Applicants Signature

Date