AKITA RESCUE SOCIETY OF FLORIDA

PRE-ADOPTION APPLICATION

Date Click here to enter a date.

Name Click here to enter name

Address Click here to enter address

Phone (XXX)XXX-XXXX

Email Click here to enter email

Which dog interests you? Click to enter dog’s name

Why? Click to enter why?

Rate in order of importance: (1-4 with 1 as most important)

Age Choose Sex Choose Color Choose Personality Choose

Where do you live? Choose property type If other Please Describe

Do you have a fenced yard? Y/N If Yes- Enter type of fence Enter type of fence Height Enter height

Would Akita need to be leash walked or could he/she exercise freely in your yard? Choose exercise

Number of adults in household? Adults Children? Children Ages of Children? Enter children’s ages

Other current pets? Enter other pets Sex of pets? Enter sex of other pets

Past pets? Enter past pets

Number of hours dog will be alone daily? Number of hours alone daily

Veterinarian? Enter name of veterinarian Phone (XXX)XXX-XXXX

Additional reference? (not related to you) Enter reference

Landlord if renting? Name of landlord Phone (XXX)XXX-XXXX

House checks are required. Purchase of a 48” crate is required. Chaining dog is not allowed. Indoor homes are required.

Additional information you would like us to know. Enter additional information