DREAM DOG APPLICATIONAssistance Canine Training ServicesPO Box 52North Conway, NH 03813(603)383-2073 Date * MM DD YYYY Contact Information Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Cell Phone * (###) ### #### Home Phone (###) ### #### Work Phone (###) ### #### Application - Please Answer the Below Questions in Full How many people live in your home and what are their ages? * Is everyone in the household in agreement with this adoption? * Does anyone in the household have an allergy to dogs? * Do you currently have a dog? If yes, what breed, sex, and age? Please list all dogs if more than one. * Do you currently administer, or plan on administering, monthly heart worm prevention? * Do you currently administer, or plan on administering, monthly flea and tick prevention? * Do you currently vaccinate, or plan on vaccinating your dog(s)? * With your current dog(s), or most recent past dog(s), what brand of dog food do/have you fed? * If you currently own a dog, should something happen to you making you unable to care for or keep your dogs, have you made arrangements for who will care for your dog or dogs? Are your dog/s or any other pets accounted for in your will? * Have you had dogs in the past? If yes, what breeds and what happened to them? * If you currently do not own a dog, but have owned a dog in the past, how long has it been since you owned a dog? * What breed(s) of dog are you interested in? * Is there a breed or sex of dog that you would NOT consider? * Do you have a cat? * Do you have other pets? If yes, what? * How many hours a day will the dog be home alone? * Where will the dog be kept when it is alone? * What is your preference regarding how energetic the dog is? * How will you exercise the dog? * Do you have a fenced in yard? * Do you have a dog run? * Will the dog be allowed to run free? * Are you or anyone in your household smokers? If yes, do they smoke in the house or car? * Please tell us a little about yourself and provide any other additional information that we might useful in processing this application. * References Your references should help us decide if you have the character we require to receive one of our dogs. You should select people who are NOT your immediate family. References who can specifically speak to you as a dog owner are particularly helpful. Reference #1 Name * First Name Last Name Email * Phone Number * (###) ### #### Relationship to Applicant * Reference #2 Name * First Name Last Name Email * Phone Number * (###) ### #### Relationship to Applicant * Reference #3 Name * First Name Last Name Email * Phone Number * (###) ### #### Relationship to Applicant * How did you hear about A.C.T.S.? * Conditions - I understand that the completion of this application for a Dream Dog is no guarantee that there will be a match for me or that a dog will be offered to me in any guaranteed period of time. - I understand that I may refuse any dog offered to me and that I will still remain on the list, and thus refusing a dog does not in any way affect my chances for another dog. - I understand that A.C.T.S. dogs who are released from the program anywhere between the ages of 2 months and 2 years, and that they are released for a number of reasons including health and behavior issues. - I understand that A.C.T.S. will disclose the reason(s) for the Dream Dog's release to the best of their abilities for my consideration. - I understand that owning a dog is a lengthy commitment and I am fully aware of the related expenses including, but not limited to, food, veterinary care, and grooming. - I understand that the adoption fee for a Dream Dog is $3,500 and that this fee is subject to change at any time. A.C.T.S. is a 501(c)(3) non-profit I acknowledge that by entering my name below and and submitting this application, that all the above information is accurate. Name * First Name Last Name When you click the SUBMIT button, the final version of this form will be sent to A.C.T.S. Thank you!
