[GPA-OC/LA
logo]


Adoption Application

By answering the following questions, you'll help up find greyhounds for you to choose from that are best suited to your needs, life-style and schedule. You are welcome to expand on any area or provide additional information on separate pages. Check here if additional paper is attached. NOTE: you will need to print this file before you can fill out the application.

Name(s): __________________________________________________________ ________

Address: __________________________________________________________ _________

City: _____________________________________ State: __________ Zip: _____________

Home phone: _______________________ Work phone: _____________________________

Best time to call you: Home: __________ Work: ___________ ___ Don't call me at work

Your occupation: __________________ Your spouse's occupation: ____________________

1. How did you hear about greyhound adoption? (Please check all that apply)

__ Through a friend/neighbor __ Newspaper article __ T.V.

__ Classified advertisement __ Veterinarian __ Radio __ Groomer

__ Internet posting __ Magazine __ Book __ Other

__ Other organization (please specify) ___________________________________________

__ Pet supply store (please specify) _____________________________________________

2. Why do you want to own an ex-racing greyhound? _______________________________

_______________________________________________________ ___________________

3. Where will your greyhound sleep at night? ______________________________________

4. Where will your greyhound be during the day or when you are not at home? ___________

_______________________________________________________ ___________________

5. Do you currently have any other pets? __ Yes __ No

If yes, please specify what kind and their ages. ____________________________________

_______________________________________________________ __________________

_______________________________________________________ __________________

6. Are the above mentioned animals house pets or do they live strictly outdoors? __________

_______________________________________________________ __________________

7. Have you owned dogs previously? __ Yes __ No

If yes, please give details such as size and breed. __________________________________

_______________________________________________________ __________________

8. Where are the pets today?

__ Died of natural causes __ Killed in accident (such as hit by a car)

__ Returned to adoption agency or shelter __ Sold __ Lost/stolen

__ Put to sleep due to illness __ Gave away

__ Other: _______________________________________

9. If you rent or lease, do you have permission from your landlord to have a large dog?

__ Yes __ No

You may be asked to provide your landlord's phone number. Is this a problem?

__ Yes __ No

10. Do you live in a: __ Single family home __ Apartment __Condominium

__ Mobile home __ Other (please specify) ____________________________________

11. If you have a completely fenced-in yard, approximately how tall is your fence?

__ less than 3 ft. __ 3-4 ft. __ 4-5 ft. __ 5-6 ft. __ No fence

12. If you have no fence, are you willing and able to take your greyhound outside on a leash

several times a day to relieve itself? __ Yes __ No

13. After you adopt, will you be willing to answer an occasional questionnaire about your new

dog? __ Yes __ No

14. On a scale of 1 to 5 (5 being highest), rate yourself:

__ 1 ____________ 2 _______________ 3 ________________ 4 __________________ 5

Not very dog-experienced <----------------------------------------> Extremely dog-knowledgeable

15. Do you currently have a veterinarian? __ Yes __ No

If yes, please list your vet's name, address, and phone number: _______________________

_______________________________________________________ ___________________

_______________________________________________________ ___________________

This application, if approved, will become part of the greyhound adoption agreement.

I certify that all statements made by me on this application are true and correct. I have read and agree to abide by the nine Adoption Requirements. If I qualify and receive a greyhound from GPA- OC/GLA, I will accept full responsibility for the greyhound.

I also understand that to complete the processing of this application, a visit to my home will be scheduled by a local representative of the adoption program. By submitting this application I agree to such a scheduled visit. I certify that all information provided by me on this application is true and correct.

Signature: __________________________________________ Date: __________________

Send the application to:

Greyhound Pets of America OC/GLA
c/o Joyce McRorie
9642 Bay Meadow Dr.
Huntington Beach, CA 92646
(714) 962-0789