Viva NM Adoption Form

1. Applicant(s) Contact Information:
(please fill out for the adults in the household)

Adopter 1 Name:
Adopter 2 Name:
E-mail Address:
Physical Address:
Phone Number:

Best time to be reached?
How did hear about Viva?

2. Applicant(s) Basic Information

Adopter1 Occupation:

Employer:

Average Work Hours:

Hobbies:
Adopter2 Occupation:

Employer:

Average Work Hours:

Hobbies:

Reference 1 (name,number, and relation):

Reference 2 (name,number, and relation):

Veteranarian Reference:

3. Home and Living Situation:

Please describe the type of home you live in:

Do you rent or own your home?
Rent Own
If you rent, what is the pet policy?:

Does your home have a fenced in area? If so, describe fence material and height:

If no fenced in area, how will you be able to safely excercise your pet daily?:

How many hours on average will your dog be left alone?:

Where will your dog or puppy be left while you are away?:

Where will your dog or puppy be when you are home?:

Please list age and gender of all household members:

Are there any children under 8 regularly visiting your home?
Do you plan on having children within the next 5 to 10 years?

4. Past Pets & Future Accomodations

Please list current animal species/breed/age/gender in your home:
Have you ever surrendered a pet to a shelter?:
Have you ever had to give up a pet for any reason? if so, why? and what happened to the pet?

If in a relationship, what would happen if you were to get a divorce or seperate?:

What would happen if you had to move unexpectedly?:
Do you plan on moving out of the state in the next 12 months?:
Do you plan to move into a different home within New Mexico in the next 3 months?:
Would you consider enlisting the help of a trainer or behaviorist for behavioral problems befor surrendering your dog?:
Are you prepared for any unexpected veterinary expenses that may arise in the lifetime of your pet?:

5.Looking to Adopt

Dog Name(s) I am looking to adopt:

Please describe all the reason why you are looking to adopt a new dog.
(please understand that the dog you may be interested in may not be a good match or already be pending adoption.
We will recommend a dog or puppy based on your preferences):

What training and personality type are you looking for in a new dog?:

What is the most important factor you are looking for in a prospective pet?:
Does every adult in the household agree to the adoption of this pet?:
Does anyone in the home have allergies to pets?:
What type of food do you plan to feed your pet:
Are you open to crate using/training your pet?:

6.My and/or my family's activity
would like a dog to participate in:

Do you enjoy your dog sleeping at your feet while you watch tv?:
How often will you walk your dog?:
Not often Once or twice a day A few times a week
How often will you jog your dog?:
Not often Once or twice a day A few times a week
Would you take your dog camping?:
Would you take your dog to dog-friendly parks, stores, or cafes?:
Will your dog participate in doggie sports such as agility, hunting, or sporting?:

7.The Type of Dog I am Looking For

What size of dog are you looking for?
What type of coat?
What type of breed?
Energy type?
Must be good with:
I am open to:

8.Please complete the application by filling out the following:

Viva conducts a home visit prior to adoption,
do you agree to participate in a home visit ?:
By typing your name in this box, you are agreeing to digitally
sign this application and testify that the above information is true to your knowledge. Signed by:
Date:
Please be aware that an application does not guarantee adoption of one or any of our adoptables. We do our best to ensure that each animal is placed in a well matched environment. In the event that the animal you are interested in adopting either is not a good match for your needs or is currently pending adoption with someone else we will do our best to refer other well matched animals based on your preferences. Unfortunately, some applications will not be approved to adopt.
Would you like to be recommended another pet should the pet you applied for be unavailable?
Your comments: