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Adoption Application

Thank you for your interest in adopting a dog from Peis & Strays. Our adoption application is the first step in our adoption process. For more information regarding our adoption process, please see our adoption information. Completing this adoption application, will help us make the proper match between your family and a new companion. We reserve the right, at our sole discretion, to turn down any application. By submitting this application, you are stating that you are 18 years or older and you are giving us permission to check the references listed.

Please answer all questions on following pages to the best of your ability. If you have any questions about the application, please contact us at info@peisandstrays.com.

Or if you prefer, you can download an application here, print it out, and mail the completed application to us. Our mailing address is Peis and Strays, 20A Northwest Blvd. #124, Nashua, NH 03063 and is also listed at the bottom the application.

Applicant Name:
First:     MI:      Last:  

Co-Applicant Name:
First:     MI:      Last:  

Street Address:  

City:   State:    Zip:  

Home Phone:  

Email Address:  

Applicant's Employer:  

Position:     Phone:  

Co-Applicant's employer:  

Position:     Phone:  

1)  How did you hear about us?
If other, please indicate:

2)  What do you know about the breed you are interested in adopting (temperament, health, etc)?

3)  Why do you want to adopt this dog? Please give all reasons that apply (companion, guard dog, gift, to breed, personal protection, for children, other).

4)  How long have you lived at the above address?

5)  Do you rent or own your current home?

6)  What type of home do you currently live in?

7)  If you rent, please provide us with your landlord's name and phone number.
Please note that we will contact your landlord.

8)  If you move to a location that does not accept dogs, what will you do?

9)    If you have children living in your home or that visit on a regular basis, please indicate their name, sex, and age(s).

10)  Are there other adults in the household? How many?

11)  Do all adults in the house approve of getting a dog?

12)  How many hours will this pet be alone most days?

13)  Have you ever owned a dog of this same breed?

14)  If you have other animals, please fill out the section below listing, species, breed, age and whether they are spayed or neutered.

15)  If you have owned animals in the past, what happened to those pets? (i.e. Put to sleep because of old age or health, ran away or stolen, given away to to a family member, released to animal shelter, given away through newspaper ad?)

16)  Do you take your pet to a vet annually?

17)  Are your current pets current on their vaccinations and heartworm preventative (where applicable)?

18)  Are you familiar with heartworm preventative and the vaccinations that are necessary?

19)  We require that all animals adopted from us be spayed/neutered. If you have any questions/concerns/reservations about this policy, please explain below.

20)  Are you prepared for the possibility of more than routine vet bills and care of the dog?

21)  If you have animals in the house that are not spayed/neutered, fully vaccinated, and on heartworm/flea prevention medicine - please explain.

22)  Please provide us with the name/address/phone number of your veterinarian. We will call them for a reference.

23)  Do you have a fenced yard?

24)  What kind of fencing do you have?
If other, please indicate

25)  If you DO NOT have a fence, how will your new dog be exercised and go to the bathroom?
If other, please specify

26)  Would you allow a home visit by a volunteer on behalf of rescue?

27)  Where do you plan to keep your new dog the MAJORITY of the time?
If other, please specify where

28)  Where will your new dog sleep at night?
If other, please specify where

29)  What will you do with your new dog when there is no one home?
If other, please indicate

30)  What will you do if your new dog exhibits bad behavior? ie..being destructive, soiling the house, barking, etc.

31)  Do you understand that a dog may not be housebroken and are you willing to take the time to properly housetrain?

32)  Do you understand that it may take this dog time (at least 30 days)to adapt to his new environment and family?

33)  What are your preferences for your adopted dog? ie..age, sex, color, etc.

34)  Would you be willing to adopt a dog with a medical condition (allergies, thyroid problem, etc). Note: We will not adopt out a dog with a major medical problem such as cancer.

35)  Would you be willing to adopt a dog with a behavior problem (chewing, separation anxiety, fear of thunderstorms, not housebroken, etc.) Note..we will not adopt a dog that is aggressive or has bitten before--under ANY circumstances.

36)  Did you see a particular dog on our website that you are interested in? If so, please indicate below

37)  Please give 2 references, one must be professional.

38)  Please write any additional comments below. Use this space to also indicate any health or behavior problems that you could NOT handle or why you think we should consider you for adoption!

By submitting this form, you acknowledge that all information provided is correct and that you are seriously interested in pursuing the adoption of a dog from this Rescue Organization. You also acknowledge that any misrepresentations of fact may result in the removal of the dog from your home.


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