Adoption Application

Home Information


Who else lives in your home?

Resident 1


Resident 2


Resident 3


Resident 4


Resident 5


Resident 6


Resident 7





What other animals live in your home?

Pet 1


Pet 2


Pet 3



Note: We are required to contact your veterinarian for medical history to meet the standards for our certification with Assistance Dogs International (ADI).

Employment Information


School Information


Canine Information

Please provide the date of current vaccinations for all dogs currently living on your property






*An adoption candidate must be able to communicate with the dog either verbally or using a signed language.




Remember that this dog has already been through some training and will not be necessarily be content with just “being a dog”. You may want to consider additional obedience training, agility trials, or rally class competition to keep them mentally and physically active.

Please provide two character references from non-relatives:

Reference 1:*


Reference 2:*