First Name Last Name
Co-Applicant: First Name Last Name
Is the Co-Applicant in favor of Adopting a Greyhound Choose Yes No
Address
City State
Home Phone E-Mail
Occupation

Number of Children Living in the home Their ages
What do you live in? choose House Mobile Home Apartment Condo
Do you: Choose Own Rent
If you rent what is your landlords name? Phone Number
Would you object to an inspection of the premises by a representative of GPA-Oh? Choose Yes No

How many hours a day will the greyhound be alone? 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Are you willing to crate the greyhound when it is alone? Yes No
Do you have a fenced yard? Yes No If yes what height and type?
If you do not have a fenced yard are you committed to leash walking your greyhound? Yes No
How would you describe the level of activity in your home? choose Quiet Normal Active
Have you previously owned a dog? Yes No If so what type?
How long was the dog with you?
Why is the dog no longer with you?

Please list all pets with you?

Routine food and medical costs for a greyhound run about $500 per year. Are you willing and able to provide the funds for food and medical care? Yes No
Where did you hear about GPA Ohio?

References:
Do you currently have a veterinarian? Yes No
If yes what is his name? Phone number
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Please list two personal references (not related)
Reference 1
Name Relationship
Phone Number
Reference 2
Name Relationship
Phone Number
 

Greyhound preferences
Do you prefer: Choose Male Female Either
Would you consider a senior age 7+) or special needs greyhound: Yes No
 

Adoption fee
Our adoption fee of $200 covers the cost of spay/neuter, vaccinations (if needed at time of adoption), teeth cleaning, and heartworm/intestinal parasite check. These services will be performed by veterinarians participating in our adoption program, unless other prior arrangements have been made by GPA-Oh.

I understand that in order to complete processing of this application, a visit to my home may need to be scheduled by a representative of GPA-Oh. By submitting this application, I agree to such a scheduled visit. I also certify that all information on this application is true and correct.