Information About You:

    Name of Dog Instested In/Breed:

  • Your Name

  • Day Phone

  • Evening Phone

  • Address

  • City

  • State


  • Email

  • Basic Information:

    How did you hear about OREBA Rescue Network Group?

  • Why do you want to adopt a dog?

  • How many years of experience do you have as a dog guardian?

  • What type of dog are you interested in?

  • Sex:

  • Age range?

  • Color?

  • Hair type?

  • Activity level?

  • Type of activity?

  • Size?

  • Where would the dog stay during the day?

  • Do you have an enclosed yard?

  • How tall is your fence?

  • Where will your dog sleep/which room?

  • How long will the dog be home alone?

  • If gone too long for a dog's bathroom needs, can you go home mid-day to take the dog out?

  • Where will he/she stay?

  • Who will be primarily responsible for the dog's care?

  • Do all members of your household want a dog?

  • If no, please explain?

  • Do you know that dogs should get yearly vet exams?

  • How many days per week will you walk your dog? For how long/distance?

  • Your walk speed: Slow, Moderate or Fast pace?

  • Do you plan to jog with your dog?

  • If needed, will you take your dog to Doggie Day Care, Dog Parks or Socials?

  • Any special activity?

  • Are you planning to obedience train your dog?

  • Have you taken any dog training classes before?

  • If so, name of school or trainer?

  • What will you do if your dog develops behavior problems?

  • Do you have a vet?

  • If so, may we contact them for reference?

  • Vet name:

  • Vet phone:

  • Vet Address:

  • Vet City:

  • Vet State:

  • Vet zip code:

  • Do you understand that you will be sharing your life with a dog for 14-18 years, who is totally dependent on you for food, shelter, health, and verterinary care? Are you willing to make this long term commitment to a dog as a family member?

  • Family Information

    How many adults in your household? (including yourself)

  • How many children in your household?

  • Ages of children?

  • Has your child lived with a dog in you home before?

  • Do you have children visiting?

  • If so, how often?

  • Ages of children?

  • Do you have pets currently? If so list type of animal, age, sex, indoor/outdoor, and weight.

  • If you have a cat, has it lived with a dog in your home before?

  • Do you live in a?

  • Do you rent or own?

  • If you are renting, we require a signed note from you landlord/property manager that it is OK for you to have this dog.

    If renting, landlord name:

  • If renting, landlord phone:

  • Would you agree to a home visit to ensure that it is secure for the pet?


    I certify that all information in this application is true, and I understand that false information may void this application. I agree that upon adopting a bet from OREBA, I will agree and abide by their Adoption Agreement.

    Yes, I certify that this is true.

    Notes/Special instructions for OREBA Rescue Network Group:




Pet Care

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