Adoption Application - Central Coast Northern Dog Rescue (CCNDR)

Please take a moment to fill out our application to adopt one of these special animals and please complete all of the information requested.
Thank you.

*** All applicants are expected to meet the dog in person. ***

Persons who wish to apply from out of State, must do this, and make special arrangements by calling CCNDR at their own expense.

Name:

Address:

City:

Zip Code:

State:

Daytime Phone:

Evening Phone:

E-Mail Address:

Family Information
How many adults live in your home?
How many children?
Please give their ages. (Seperate by using a comma)

Pet Information
Do you have other pets?	Yes No
Please list what kinds of pets if you do. (Seperate by using a comma)
Do you have a fenced yard?	Yes No
Height of fence (approximately)
Type of fencing?

Owner Information
Have you ever owned a dog before?	Yes No
Have you ever owned a northern breed of dog before?	Yes No
What activities do you plan to do with your dog?