You can download our application here and e-mail to us or you can fill out the application form to the right and submit it online

Online Adoption Application

Thank you for choosing to adopt one of our rescued dogs and for putting time and thought into filling out our application. Our goal is to match each one of our dogs with the right person or family so that you will share a long and happy life together. The information you provide will help us do just that! Our adoption fee is anywhere between $200-500, depending on the dog. The adoption fee contributes to the cost of: spay/neuter, microchipping, vaccinations, wellness exam, boarding, transportation and pull fees, monthly heartworm and flea/tick prevention, food, treats, toys, as well as daily socialization and activities, along with some basic training. Occasionally a dog in our care requires additional and often expensive medical care and/or professional training. Donations are always welcome!
Foster Application
Please do not skip questions.    Please let us know after you submit an application.  You can e mail us at Thanks!
Name of the dog you are interested in adopting:
What do you know about this breed? Why this dog?
Co-Applicant Name
Do you own or rent your home?
Co-Applicant Address
Co-Applicant Phone:
Co-Applicant Age:
Co-Applicant Occupation:
What describes your household setting: Single/Married
Co-Applicant E-mail:
Do you have a preference in terms of breed, size, age, gender? If so, please specify:
Most valued qualities you want? Low energy/Companion; Cat/dog/'kid/people friendly; watch dog; easy going; active; playful; smart; high energy; special needs (medical or emotional); senior; other
Current Address
Would you describe your home as suburban or Rural?
Do you live inApartment/Condo/Townhouse/Duplex or Mobile home
How long have you lived at this address?
Do you plan to move from this address? If yes, please provide additional details:
If you rent your home, please provide the following information: Landlord's name:
Landlord's Phone Number:
What is the size of your yard? ____________ feet by ___________ feet
Is your yard fully fenced/partially fenced/ or Not fenced?
How do you plan to exercise your dog? daily walks/running/dog park/play time/free reign of yard?
What do you imagine your life with your dog to be like?
Are you fairly new to pets and eager to learn more?
Are you Fairly new to pets but not looking to learn a whole bunch, just looking for a companion
Are you familiar and comfortable with pets, know the basics?
Are you very experienced with pets, able to train your own dog?
Are you familiar with positive reinforcement?
Are you educated in diet, grooming, health issues?
Are you a highly skilled handler of all types of pets, able to help a dog that may have issues?
Provide names and ages of all individuals who will live with or interact with dog
Have these individuals had any previous dog exposure?
Does anyone in your house have animal allergies?
If yes for allergies, how do you plan to address the issue?
What other animals live in your house - give names/breeds/ages/medical issues of each pet
Are all dogs/cats in your house spayed/neutered? Are they all up to date on their shots? If no, why not?
Have any of your dogs ever bitten anyone or shown any signs of aggression towards another dog or a person?
If yes, please explain circumstances and what triggered, outcome, etc.
Do you know how to break up a dog fight? If yes please explain
Have you ever been bitten by a dog? If yes, how has it affected your comfort level with dogs?
Have you ever surrendered an animal to a shelter/relative/friend/stranger?
If yes, please explain
What type of dog food will you be feeding:
Daily work schedule of applicant/co-applicant:
Estimated amount of time your dog will spend alone each day:
Where will the dog stay when no one is home:
Where will the dog sleep at night:
Describe the general lifestyle and energy level of the household:
Vet Reference Name:
Vet Reference Phone #
Reference #1 not related or living in your home/name and phone #
Reference #2 not related or living in your home/name and phone #
Reference #3 not related or living in your home/name and phone #
Do you travel often?
If Yes, where will your pet stay and who will watch your pet?
Are there habits/problems you won't allow, i.e. chewing, excessive barking, separation anxiety, not housebroken?
Under what circumstances would you not keep your dog? Be specific
Have you ever adopted from a rescue group before?
If yes, name of group you adopted from
Do you realize your dog may need a transition period to become accustomed and comfortable?
Are you aware we require a home visit prior to adopting as part of the application?
Are you aware that our adoption fee is $220-$500?
Applicant's Signature
Co-Applicant's Signature
If the dog you want is no longer avail would you want us to process your application for another similar dog?
By completing the above application to the best of my ability, I certify that all information is true, and that any false information may result in nullifying the adoption.
If you have been using this veterinarian for less than 2 years, please list any previous vets and their phone numbers.
**Please note: Most vets are required by law to have permission by owners prior to releasing any information, to help speed up the processing of this application, please contact your vet ahead of time and tell them we will be calling**
Please send an e-mail to us after submitting your form so we are sure to look for it.   ( Thanks.
Please be reminded that filling out this application does not guarantee adoption eligibility and/or that the specific dog you are applying for will be available.
Thank you for your interest in a rescue dog!  If you do not hear from us please contact us at
Nepa Pet Fund and Rescue