EmailMe Form - Nobody's Perfekt Dogs Adoption Application

Nobody's Perfekt Dogs Adoption Application

We are here to help match you with a dog who will be your lifelong companion. By submitting this application, you give Nobody’s Perfekt Dogs permission to investigate and confirm any information you have provided. Our goal is to insure the welfare of the animal by placement in the best possible home.

Please note our adoption requirements:

* Renters: we check with the landlord regarding the pet policy

* Large dog (over 30 lbs) adopters: we require that you own your home

* We do a home check before approving any application

* WE DON'T ADOPT OUR DOGS OUT TO FAMILIES WITH CHILDREN UNDER THE AGE OF 13.

* We require approved applicants to take the dog on a “sleepover” for a few days before deciding to adopt

* We don’t typically adopt our smaller dogs to homes with large dogs

* All of the other dogs living in the home need to be spayed / neutered

* We don't typically adopt to homes outside of the San Francisco bay area. We can make some exceptions. If you live outside our adoption area, please contact us first, before completing this application.

* We don’t adopt our younger dogs to senior households

* We reserve the right to deny any adoption application for any reason.

Unique ID
What is your reason for wanting to adopt a dog? *
Companionship
Save a dog's life
Playmate for another dog
Security
Teach children responsibility
Emotional Support / Service Dog
Other
Check all that apply
For which dog(s) are you applying? *
Why are you interested in this particular dog? *
If the dog you are applying for ends up not being a good fit for your situation, would you consider another Nobody's Perfekt Dog that may be a better fit? *
Yes
No

Is an imperfekt dog a good fit for your situation? *

	Strongly Agree	Agree	Disagree	Strongly Disagree
I want to help a dog that has behavioral or ongoing medical needs
House training is an absolute must
I am okay with a dog that needs a long period (weeks?) to adjust to a new home
I am willing to work around what the dog is comfortable with and NOT comfortable with
I have experience with separation anxiety dogs
I can work with a shy dog
I am okay with a dog that isn't comfortable with strangers
I am okay with a dog that doesn't like other dogs
Most dogs may snap/nip/bite if they are scared enough
Barking is just part of having a dog
The breed and appearance of the dog is important to me
I would never own a Chihuahua

We are primarily a "special needs" rescue. What behaviors or disabilities are you willing to work with? *
Mobility issues (cart, drag bag, etc.)
Feral or under-socialized dogs
Chronic medical condition (heart disease, kidney disease, severe allergies, etc.)
Dogs that have seizures
Hospice / senior dogs
Incontinent (diapers)
Blind or deaf dogs
Leash or barrier reactive
Abused dogs
Dogs with bite histories
None of the above
Other
Check all that apply.
Applicant Information
Applicant Name *
First Last
Applicant Email *
Applicant Cell Phone *
### - ### - ####
2nd Applicant Name (optional)
First Last
(Spouse, partner, other adult in the household, if you want to include this information)
2nd Applicant Cell Phone (optional)
### - ### - ####
2nd Applicant Email (optional)
Street Address *
City *
Zip Code *
Home Phone
### - ### - ####
How did you hear about Nobody's Perkekt Dogs? *
Adoption Center
Our website
Our Facebook page
Referral from a friend
Brochure
Adopt-a-Pet.com
PetSmart.com
PetSmart adoption event
Pet Food Express adoption event
Petco adoption event
Other
Type of home: *
House
Condo
Apartment
Mobile Home
Other
Does the home have a yard? *
Yard with a fence
Yard with no fence
Enclosed deck or patio
No yard / deck / patio
Other
Own or rent? *
Rent
Own
Live with parents/relatives
Other
If you rent, do you have your landlord's permission to have a dog (or another dog)? *
Yes
No
Not Applicable
We will need to confirm the pet policies with your landlord before the application is approved.
Landlord's name and phone # (if applicable).
Apartment Complex Name (if applicable)
How long have you lived at your current address? *
Years / months
Do you plan on moving? *
No
In 6 months
In 1 year
Other
If you do move, what will happen with your animals? *
Take our pets with us
Find family or friends to take our pets
Take the pets to the shelter
Let them loose on the streets and hope they find a new home
Other
Number of adults in the household *
Does this home qualify for our "Seniors for Seniors" program? *
Yes
No
We try and place our senior dogs in senior homes (over the age of 70). Nobody's Perfekt Dogs will support the dog's vet expenses for the remainder of the dog's life.
Number of children in the household and their ages.. *
NOTE: Nobody's Perfekt Dogs does not adopt to homes with children under the age of 13.
Are you planning on having children in the future? *
No
Yes
Other
Who will ultimately be responsible for the care of the dog? *
Does anyone in the household currently have or had allergies to pet fur and/or asthma? *
Cat Fur
Dog Fur
Asthma
No Allergies
Does everyone in the household agree to adopting a dog or puppy? *
Yes
No
Will this dog be a gift or surprise for someone else? *
Yes
No
What is your level experience with dogs or puppies? *
Is this your first dog or puppy? Have you had troubles in the past with dogs?
Have you ever relinquished a dog (or other pet) to an animal shelter, rescue group or someone else? If yes, please explain the circumstances. *

Please list all animals currently living in the house (note: all other dogs living in the home MUST BE FIXED):

	Type (dog, cat, bird, etc))	Name	Gender (Male, Female)	Fixed? (Yes, No)	Weight (lbs)	Age	Breed
Animal 1
Animal 2
Animal 3
Animal 4
Animal 5
Animal 6
Animal 7
Animal 8
Animal 9
Animal 10

Any health or behavioral issues with existing pets?
What will your family do to help the dog adjust to its new home, new family and other pets in the household? *
How much time will allow the dog to adjust? *
A day? A few days? A week? etc.
How many hours a day will the dog be left alone? *
What will you do with the dog if you plan on being gone for a few days? *
Leave the pets with friends or family
Board at a kennel
Use a dog sitter / house sitter
Leave in the house alone with enough food / water
Leave in the backyard alone with enough food / water
Other
Check all that apply.
Where will the dog spend most of its time? *
At home
I plan to take the dog to work with me
I plan to take the dog everywhere with me
Other
Where will the dog be kept when SOMEONE is at is home? *
Indoors
In a crate
Outdoors
Other
Where will the dog be kept when NO ONE is home? *
Indoors
In a crate
Outdoors
Other
Where will the dog sleep at night? *
Indoors
In a crate
In the bed
Outdoors
Will the dog be allowed on the furniture (couch/chairs)? *
Yes
No
Other
What are your expectations for house training? *
PLEASE NOTE - Nobody's Perfekt Dogs never guarantees that a dog is house trained. There are many contributing factors for successful training (other dogs in the home, a doggy door, how many walks per day, the dog's comfort level in a new home, etc.). YOU SHOULD ASSUME THAT THE DOG WILL NEED SOME HOUSE TRAINING IN YOUR HOME.
Do you currently have a vet and if so, what is the name of the clinic or vet? *
How often should your dog visit a veterinarian? *
2-3 times a year? Once a year? Once every 2 years? etc.
What are your anticipated vet costs per year? *
Have any of your current pets been diagnosed with an infectious disease or other conditions?
Such as heartworm, distemper, parvo, bordetella, etc.
Do your pets currently use flea/tick protection?
No other pets
No
Yes (What kind?)
What is your plan for when the dog nears the end of its life? *
Love and care for the dog until it is time to say goodbye
Give the dog back to Nobody's Perfekt Dogs
Take the dog to a shelter
Let the dog loose on the streets
I plan on the dog outliving me
Other
I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND THAT ANY FALSE INFORMATION MAY RESULT IN DENAIL OF THE APPLICATION. *
YES
Name *
Print Full Name
Today's Date *
MM / DD / YYYY

Applicant Information