Adoption Application

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Mail to: PO Box 614, Bangor, PA 18013       Call: (267) 217-DOBE       Email:
Please note: This application will require approximately 1 hour to properly complete. Please devote yourself to this time frame and gather all necessary information beforehand in order to complete the application in its entirety. We will not process incomplete applications. If a field does not apply, please write “N/A”, otherwise we will assume that you have skipped the question. Please also take the time to contact the veterinarians listed and give them permission to release information to us. Many offices will not provide records to us unless they have your authorization, and we cannot approve an application without this information.
Personal Information

5 digits only

Additional 4 digits

NOT country
Living Arrangements & Daily Care

Specify whether years or months

Select all that apply

(ie: family vacation, family emergency, etc.)

How often, what time, free fed, etc.

Household Information

Write "N/A" if no others

Neighbors, friends, grandchildren, etc.

Current Pets

Please click the link to the right to add a new line for each additional pet
Click here to add another pet

Previous Pets

This information MUST be provided for ALL previous pets owned by BOTH applicants since age 18, regardless of whether they are deceased or were sold, re-homed, returned to a rescue, etc.
Click here to add another pet

Experience and Preferences

If you have not owned this breed before, please describe the resources where you have gathered information.

Check all that apply

Check all that apply

Check all that apply

Check all that apply

Please understand that even the most housebroken dogs still require an adjustment period when going to a new home and can have accidents.

Check all that apply

Please specify how important the following characteristics are when finding a dog for your family.

Please select only 3

Training & Behavior Views

If you plan to use a particular trainer or style of training, please include that information here.

(ie: aggression, allergies, housebreaking issues, moving, medical issues, etc.)
Please DO NOT list family members below. We recommend neighbors, friends, co-workers, etc.


Please click the link to the right to add a new line for each additional organization
Click here to add another organization

Check all that apply.

Please feel free to list any comments you have or to expand upon any responses that you did not have enough room to explain.
Terms of Application Submission
PLEASE NOTE: You must check EVERY box below. If you do NOT agree with ALL of the items below, we apologize but we will not be able to process your application.

Please read each line above, then check the box to acknowledge that you agree with each statement.
By signing below, I agree to the above terms and confirm that the information I have provided above is true and correct to the best of my knowledge. I also agree that by submitting this form electronically, I authorize my initials below to be used as a valid and legal substitute for my written signature.