Adoption Application Form

Adoption Application

Please note: All required fields must be completed for your application to process.

Step 1 of 5

About You and Your Family
* indicates required field
Applicant Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Applicant Age (must be 18 or older):*
Co-Applicant Name
First Last
Co-Applicant Age:
Relationship of applicant and co-applicant:
Names/ages of all other humans in the household:*
Other Children:*
If you do not have children living in your home, will your adopted dog come in regular contact with children (e.g. grandchildren, etc.)?
If yes, please indicated ages and anticipated contact frequency:
Home Phone
Req'd Contact Information
The following contact information must be provided or your application cannot be processed.
Mobile Phone*
Do we have your permission to text you to set up a phone interview?*
- Yes
- No
Email address:*

If we do not have permission to text you, we will email to set up a phone interview. Special note: Please watch your spam folder for any email replies regarding approval of your application. This is especially important for anyone with an @gmail.com email address. If you have not heard from us within a week of submission, please call at 717-484-4799
Applicant's Occupation:
Co-Applicant's Occupation:
How should we contact you?
What is the best time to contact you?
How did you learn about DVGRR?
If friend/family, please provide their name; if "other," please describe:
Have you previously adopted from DVGRR?*
If yes, please enter dog's name and DVGRR ID #:

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About Your Home
*indicates required field
What type of home do you reside in?*
If other, please describe:
Do you own or rent your home?*
If renting, do you have written permission from your landlord to have a dog over 50 lbs?*
Do you have a physical or electronic (invisible) fence that completely encloses part or all of your yard?*
Please remember that we place dogs into homes without a fenced yard ONLY on a case-by-case basis! For a fenced yard, please provide approximately five pictures (can be taken from a cell phone camera) concentrating on: Where your fence joins your house, gate areas, where the fence meets the ground or any gaps, the front of the house with house number visible, if possible, any other areas that may be of benefit. Email the photos to Gateway@dvgrr.org and we ask that you include the name that your application is under in the email to avoid confusion.
If physical fence, describe fence material; if electronic fence, describe manufacturer and installer:
Fence height (for physical fence):
Area that is enclosed:
If other, please describe:
Approximate dimensions of fenced area (length by width or acreage):
Where will the dog reside/have access to when no one is at home?
Will your dog have access to outside your home on its own? (e.g. doggie door)
If yes, will the dog have access to these when you are not at home?
Please list all other current pets in the home (Indicate type, breed, age, and whether spayed/neutered):
Please describe how your other pets get along with dogs:
For applicants with no current dogs, will your adopted dog(s) regularly interact with other dogs (e.g. those of family, friends, neighbors, etc.)?
If yes, please describe:
Does anyone in the household have any special needs to consider when adopting a dog?*
If yes, please describe:

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Dog Ownership and Experience
* indicates required field
Will this be your first dog?*
Will this be your first Golden or Labrador Retriever or Doodle?*
Have you ever sold, given away, or surrendered a pet to a shelter?*
If yes, please describe the circumstances:
Do you plan to breed dogs?*
If yes, please describe:
Are you familiar with the use of a dog crate to train and/or confine the dog while they are unsupervised?
If yes, have you used a crate with a previous dog?
If your adopted dog requires it, are you willing to crate train and use a crate?
DVGRR recommends using a high quality food. Are you willing to do this and/or make this change from previous food you have used?
If no, please explain:
DVGRR dogs need daily exercise. How will you accomplish this?
How do you plan to train your dog to be a well-mannered member of the family?*
Please be as specific and detailed as possible.
Do you plan on taking obedience or training classes with your dog?
Have you ever taken an obedience or training class with a dog? If yes, please indicate when and the type of training
Do you or a family member have a certificate in dog training/obedience? If yes, please describe:
If your adopted dog develops a serious behavioral or training problem at some point in his/her life, are you prepared to obtain necessary/appropriate training or behavior consultation?
If no, please describe any limitations you anticipate:
Have you or a family member ever participated in any dog-related activities?
(e.g. conformation, obedience, agility, flyball, animal-assisted therapy, etc.)
If yes, please describe:
Are you aware that routine costs of maintaining a dog average $1,200 to $1,500 per year?
If your adopted dog develops a serious illness, injury, or health condition at some point in his/her life, are you prepared to obtain necessary/appropriate veterinary care?
If no, please describe any limitations you anticipate:

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6677 Adopted!

Adoption Application

Adoption Application

Step 1 of 5

About You and Your Family

Req'd Contact Information

About Your Home

Caring for Your Dog

Dog Ownership and Experience

Breed Information and Preferences

Veterinary Information Request

DVGRR Policies: