Adoption Application

Name*

Phone (Home)

Phone (Cell)

Phone (Work, Fax, Pager, Other)

Address*

Street Address Address Line 2 City State ZIP Code

Age of Applicant*

Email Address*

How long at this address?*

Residence*

Own
Rent

Please upload a lease or letter stating you are allowed to have a large dog on the premises:

Max. file size: 300 MB.

Who else lives with you (including children)?

Enter information below about each adult and child (if none, enter N/A in each field)

Name	Relationship	Age

Name	Relationship	Age

Name	Relationship	Age

Name	Relationship	Age

Name	Relationship	Age

Name	Relationship	Age

Name	Relationship	Age

Employed*

Enter employment information below for each adult in the household (if none, enter N/A)

Occupation	Work Hours

Why do you want to own a Lab?*

How soon do you hope to adopt?*

List previous dogs

Include their breed and what happened to them.

List current pets

Name, Breed, Age, Gender, Spayed or Neutered and anything that CILRA should know about this pet.

Enter information below for each additional current pet.

Pet Name	Breed	Age	Gender	Spay / Neuter	Additional Info

Additional current pet

Pet Name	Breed	Age	Gender	Spay / Neuter	Additional Info

Additional current pet

Pet Name	Breed	Age	Gender	Spay / Neuter	Additional Info

Additional current pet

Pet Name	Breed	Age	Gender	Spay / Neuter	Additional Info

Name, Address, Phone # of current vet.

Is someone home during the day?*

Where will the Lab be during the day?*

Where will the Lab be during the night?*

Fence?*

Fence Type & Height*

If no fence, how will you confine your dog to your property? (Please note CILRA's policy that homes with children under 10 yrs. of age must have an invisible fence or a traditional fence)

Describe your exercise plan for your Lab.*

Describe plans for care of your dog while away*

Are you willing to obtain a crate and crate train your dog?*

No
Yes

Are you willing to take your dog to an obedience course?*

No
Yes

If not, why?*

Are you willing to have a CILRA rep visit your home? (By appointment)*

No
Yes

What behaviors would cause you to give up your dog?*

Describe the type of dog that would fit best with your family.*

How far are you willing to travel to meet a foster dog?*

0-1 hours
2-4 hours
4-6 hours
6-8 hours

What is your Lab color preference?

Please list in order your color preference. Yellow, Black, and Chocolate. If you do not have a preference, please list No Preference.

Option 1	Option 2	Option 3

What is your Lab gender preference?

Please list in order your gender preference. Male and Female. If you do not have a preference, please list No Preference.

Option 1	Option 2

Lab Age Range (check all that apply)*

0-6 months
6 months-1 year
1-2 years
2-5 years
5+ years

Would you consider a Lab mix?*

In most cases, this may simply mean the dog is a bit smaller than a purebred, or has a slight color variation not allowed by purebred standards, but still has the general characteristics and temperament of a Lab.

No
Yes

Would You Consider Fostering to Adopt?*

Yes
No

How did you hear about CILRA? (please be specific)*

Comments

Email

This field is for validation purposes and should be left unchanged.

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