Contact Us

Name *
Name
Phone *
Phone
Physical Address *
Physical Address


Baytown

We have a No Kill mission to save the lives of animals abandoned and/or placed in kill shelters. Through outreach, education, and service, we provide homeless cats and dogs with an opportunity to live their full life. 

Canine Adoption Application

CANINE ADOPTION APPLICATION

To be eligible to adopt from A LIFE TO LIVE you must:

1.  Be at least 18 years of age.

2.  Be able to financially provide shelter, food/water, and preventive and emergency veterinary care for the full life span of the animal adopted.

3. Not have been convicted of animal cruelty.

The information provided within this application will help determine an approval or denial of your eligibility to adopt. We encourage you to take your time and provide sufficient detail and explanation to the questions asked. 

If online, please provide the name of the website. For Example: Adopt-A-Pet, Petfinder, Facebook or A Life to Live's main site.
Applicant Information
Name *
Name
Home Address *
Home Address
Primary Phone Number *
Primary Phone Number
If you are retired or not employed, please indicate that and provide an explanation of what your time is spent doing.
What is your Age Range? *
Home Dwelling *
Please select the type of dwelling that you use as your primary residence.
Living Situation *
Please select wether you own or rent the dwelling that you are currently living in.
Please list the renter/leaser name and contact information.
Does your lease allow pets? *
Does your lease require a pet deposit? *
Please list any breed or size restrictions that your location may have. (city, county, lease, apartment, etc.) If there are no restrictions, please input N/A.
Home Environment
Home Visit *
If requested, would you allow A Life to Live to conduct a home visit prior to approving the adoption?
Please input the number of adults (18 + years old) that live in your home.
Please input the number of children (less than 18 years old) that live in your home.
Please provide the age of each child living in the home.
Allergies *
Is someone in your home allergic to dogs?
Pet Information
First Time Dog Owner? *
Please indicate if you are a first time dog owner.
Please include the following information, regarding your current pet(s), in the text box below: (If you have never owned a pet before, please type N/A in the box below) 1) Pet's Name, 2) Sex, 3) Species/Breed, 4) Age, 5) Years Owned, 6) Spayed, Neutered or Not Fixed 7) Current on Vaccinations?
If they no longer live with you, please explain why. If you are a "First Time Dog Owner", please type in N/A.
If you don't have any current pets, please input N/A.
Do you currently have an indoor cat? *
Is your indoor cat dog-friendly? *
If this doesn't apply to your application, please select N/A.
Are you looking to adopt a dog as a companion for a cat? *
If this doesn't apply to your application, please input N/A.
If this doesn't apply to your application, please input N/A.
Experience and Pet Ownership
What experience do you have with animals? (current or previous pet owner, fostering, rescuing, volunteering, training, etc.)
Have you had to surrender, re-home, sell, give away, or put down a pet in the past? *
If you have surrendered, re-homed, sold, given away or put down an animal in the past, please explain why. Please also explain who or where you surrendered, re-homed, sold, gave away, or put down your pet. (If a shelter, please name the shelter.) If you selected no, please input N/A.
Veterinary Information and Medical Care
Heartworm Preventative *
Are your pets currently on heartworm preventative? If you don't currently have a pet at home, or if you are not familiar with heartworm preventative, select N/A. If you don't provide your pet with heartworm preventative, please select No.
Please input the type of heartworm preventative you will use.
Please list the veterinary clinics/hospitals (including mobile clinics) that you have used for routine care in the past 5 years. Please include: 1) Veterinarian's Name, 2) Phone Number, 3) City/Location. (If you do not have a veterinarian, please type NO VET)
May we contact the veterinarian(s) listed above? *
Initial Health Exam *
Will you take your new pet to your designated vet for a general health exam within 72 hours of adoption?
Formal Commitment and Financial Responsibilities
Formal Commitment *
Dogs often live between 10-15 years. Are you prepared to make the commitment to care for this dog for the full duration of their life?
Financial Responsibility *
The estimated yearly cost of caring for a dog is $1,500.00. Can you afford the financial cost of owning this dog?
Interests
Please explain why you are interested in adopting a dog/puppy.
What kind of dog are you looking for? *
Please check all that apply.
What activity level do you want in a dog? *
Personality Traits Wanted *
Please check all of the below traits that apply to what you're looking for in a dog.
Exercise and Training
Regular Activities *
What activities will you engage in with your dog on a regular basis (at least 4 times a month). Please select all of the activities that apply.
Training *
Many of the dogs we adopt out have not received any formal training. If necessary, would you be willing to seek professional help to train your dog?
How will you train your new puppy/dog? What techniques will you use for house-training, obedience training, etc.
Potential Training Obstacles *
What issues would you NOT be willing to work on with your dog? Please select all that apply.
Have you ever had to overcome a behavioral or training obstacle with a current or past pet? What was the obstacle, what steps did you take, and what was the outcome?
Reasons to Rehome or Relinquish a Dog *
Please select the below reasons that you would consider being valid to give up your dog.
OPTIONAL: Please feel free to expand on why you selected the above reasons for potentially rehoming or relinquishing a dog.
Home Preparation
Do you have a Fenced-In Yard? *
Please describe the type of fence (if wrought iron, please include the space between posts), the height of the fence, and indicate if it is completely closed in or not.
Do you have a Doggy Door? *
Please explain how you and your family have prepared for the responsibilities of adopting a puppy. If this doesn't apply to your application, please input N/A.
Explain what a typical day would look like for you and your pet. "A day in the life of your dog."
Authorization
I hereby authorize A Life to Live to check my references. I certify that the information provided by me in connection with my application, whether on this document or not, is true and complete. I understand that any misstatement, falsification, or omission of information shall be grounds for termination of this application. A Life to Live reserves the right to refuse any adoption. By typing/signing my name below, I agree with the above terms. *
I hereby authorize A Life to Live to check my references. I certify that the information provided by me in connection with my application, whether on this document or not, is true and complete. I understand that any misstatement, falsification, or omission of information shall be grounds for termination of this application. A Life to Live reserves the right to refuse any adoption. By typing/signing my name below, I agree with the above terms.
Date *
Date
INTERNAL USE ONLY
A Life to Life Representative
A Life to Life Representative
Status of Application

A Life to Live is an incorporated 501(c)(3) nonprofit organization.  © 2017 A Life to Live. All Rights Reserved.