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About Dogs by Debin
Richard Dean Norris – CO-FOUNDER
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Do you want to adopt a dog? Please complete the quick online adoption application!
Applications
Adoption Application
Your Full Name
*
First
Last
Email address
*
Partner or Spouse's Name
First
Last
Phone Number
*
Secondary Phone Number (Work, friend, etc)
*
Physical Address Where Dog Will Live
*
Street Address
City
State / Province
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Do You Have Children That Live with You or Visit? (17 years old or younger)
*
Yes
No
If Yes, What are Their Ages and How Often Do They Visit?
Is There a Specific Dog You are Interested In? (Name)
Preferred Gender?
*
Male
Female
Either
Desired Age? (Check any that apply)
*
Puppy
Young Adult
Senior
Open to appropriate fit for me
Other
Do You Have Other Indoor or Outdoor Pets?
*
Yes
No
If Yes, Please Tell Us About Them
Have You Ever Given Up a Pet?
*
Yes
No
If Yes, Please Tell Us the Circumstances
Veterinarian of Reference Name & Phone Number. (If no Vet, who do you intend to use?)
*
(Make sure you please list the phone number!)
Do You Own or Rent Your Home?
*
Own
Rent
If You Rent, Landlord's Phone Number or Explain "Other"
(Make sure you please list landlord's phone number!)
Is Your Yard Fenced? (This will not exclude you. It merely helps us find a match for you)
*
Yes
No
If Fenced, How Tall & What Material?
Please Provide 1 Personal, Non-related Reference (Name, phone number & how you know them)
*
(Needs to be non-related & we need a phone number!)
Tell Us What Temperament, Size & Any Other Information That Will Help Us Pair You With your New Friend...
*
Where Do you Plan to Keep Your New Family Member During the Day & at Night?
*
How Did you Hear About Us?
*
Radio
Television
Friend or Family
On-line Ad
Social Media
Word of Mouth
Other
Any Other Information that May be Useful?
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