Dog Adoption Application

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3. Police Department | Animal Services Division
   1950 Stevenson Boulevard<br> P.O. Box 5006<br> Fremont, CA 94537-5006<br> Phone: 510-790-6640 <br> Fax: 510-790-6632 <br> <a class="Hyperlink" target="_self" href="https://fremont.gov/">Website</a>

   1950 Stevenson Boulevard
   P.O. Box 5006
   Fremont, CA 94537-5006
   Phone: 510-790-6640
   Fax: 510-790-6632
   Website

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6. <h2> Fill out this application if there is an animal you are interested in. Filling out an application does not mean the application is approved, it is a starting place. We provide adoption counseling to make the best possible placement. Come into the shelter and we can help you find a great pet based on the needs of both your family and the animal. Your request may be denied. <h2/>

   Fill out this application if there is an animal you are interested in. Filling out an application does not mean the application is approved, it is a starting place. We provide adoption counseling to make the best possible placement. Come into the shelter and we can help you find a great pet based on the needs of both your family and the animal. Your request may be denied.

8. Family Information

10. First Name*

11. Last Name*

13. Address*

14. City*

16. Zip Code*

18. Phone Number*

19. Email*

21. Name and Ages of Others in Household*

23. Housing*

    1. Own
    2. Rent
    3. Live with Parents

24. Type of House*

    1. House
    2. Condo
    3. Apartment
    4. Mobile Home

26. Landlord Name

27. Landlord Phone

29. Landlord Approval

    1. Yes

    1. No

31. List Other Pets Currently Residing at This Address*

33. Are all family members and pets in favor of the new addition?*

    1. Yes
    2. No

34. Anyone in household have allergies to pets?*

    1. Yes
    2. No

38. Living Arrangements

40. Where will your dog be kept during the day?*

41. Where will your dog be kept at night?*

43. How long are you and your family away from home each day?

45. Hours per Day*

46. Days per Week*

48. What will you do if your dog has (or develops) behavior problems such as the following?

50. Digging*

52. Chewing*

54. Barking*

56. House Soiling*

58. Aggression*

62. Specifics

64. Have you ever owned a dog before?*

    1. Yes
    2. No

65. What breed(s)?

67. If yes, what vet did you use?

69. What happened to that dog?*

    1. Deceased
    2. Lost
    3. Gave Away

    1. Still Have
    2. Other

71. What will you do with your dog if you have to move?*

73. What activity level are you looking for in your new dog?*

    1. Low
    2. Moderate
    3. Active
    4. Very Active

77. Costs

79. Can you provide for your new dog (with the average costs of care), including the following?

81. The initial veterinary costs (not included in the adoption fee) of $60-$150 or more?*

    1. Yes
    2. No

83. Yearly exams and vaccinations ($100/year)?*

    1. Yes
    2. No

85. Licensing fees*

    1. Yes
    2. No

    See licensing fees

87. Emergency vet care ($500+)?*

    1. Yes
    2. No

89. Initial that you understand you will not receive a refund for any adoption fees.*

90. I certify that I am at least 18 years of age and all the above information is correct.*

    1. Yes
    2. No

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91. Print Only

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