Maple Haven Kennel

Adoption Application

Thank you for considering adopting a puppy from Maple Haven Kennel. Please fill out this comprehensive adoption application form to help us ensure that our puppies find loving and responsible homes. Your honest responses are vital in making the best match for both you and our puppies. All information provided will be kept confidential.

First name

Last name

Phone

Address

City, Province, Country

Postal Code

Date

Household Information

Are you over 18 years of age?

Number of Adults in the Household:

Number of Children in the household:

Ages:

Do any household members have allergies to dogs?

If you live in a house, do you have a securely fenced yard?

Lifestyle and Commitment

Do you have a regular work schedule or commitments that will keep you away from your new pup for extended periods of time?

How many hours per day will the puppy be left alone?

How do you plan to exercise and socialize the puppy?

Are you willing to attend obedience training with your puppy?

Have you ever returned a pet to a shelter or rescue organization?

If yes, please explain the circumstances:

Have you ever been convicted of animal cruelty or neglect?

If yes, please explain the circumstances:

Current and Past Pets:

List all current pets (include type, breed, age, and gender):

List all past pets (include type, breed, age, and reason they are no longer with you):

Veterinary Information:

Veterinarian's Name:

Veterinarian's Clinic Address:

Number

May we contact your veterinarian for a reference?

References

Please provide the names and contact information of two references who are not related to you:

Reference 1:

Reference 2:

Additional Comments or Information:

Declaration:

I declare that the information provided in this adoption application is true and accurate to the best of my knowledge. I understand that submission of this application does not guarantee approval for adoption. I consent to reference checks, and other screening procedures as required by Maple Haven Kennel. I agree to abide by the terms and conditions of the adoption contract.

Applicant's Signature: