Adoption Application
Applicant Information
Applicant Name
*
Address
*
City State Zip
*
,
Email
*
Home Phone
*
Cell Phone
Work Phone
Pet Information
Physical description of the pet
Any details for the type of pet you are looking to adopt
Optional: Select any specific breeds you are interested in.
Affenpinscher
Afghan Hound
Airedale Terrier
Akita
Alaskan Malamute
English Coonhound
American Eskimo Dog
Foxhound
American Staffordshire Terrier
American Water Spaniel
Anatolian Shepherd
Australian Cattle Dog (Blue Heeler)
Australian Shepherd
Australian Terrier
Basenji
Basset Hound
Beagle
Bearded Collie
Beauceron
Bedlington Terrier
Belgian Shepherd Malinois
Belgian Shepherd Dog Sheepdog
Belgian Shepherd Tervuren
Bernese Mountain Dog
Bichon Frise
Black Russian Terrier
Black and Tan Coonhound
Bloodhound
Bluetick Coonhound
Border Collie
Border Terrier
Borzoi
Boston Terrier
Bouvier des Flanders
Boxer
Boykin Spaniel
Briard
Brittany Spaniel
Brussels Griffon
Bull Terrier
American Bulldog
Bullmastiff
Cairn Terrier
Canaan Dog
Cane Corso Mastiff
Welsh Corgi
Cavalier King Charles Spaniel
Chesapeake Bay Retriever
Chihuahua
Chinese Crested Dog
Shar Pei
Chinook
Chow Chow
Clumber Spaniel
Cocker Spaniel
Collie
Curly-Coated Retriever
Dachshund
Dalmatian
Dandi Dinmont Terrier
Doberman Pinscher
Dogue de Bordeaux
English Cocker Spaniel
Foxhound
English Setter
English Springer Spaniel
English Toy Spaniel
Entlebucher
Field Spaniel
Finnish Lapphund
Finnish Spitz
Flat-Coated Retriever
French Bulldog
German Pinscher
German Shepherd Dog
German Shorthaired Pointer
German Wirehaired Pointer
Giant Schnauzer
Glen of Imaal Terrier
Golden Retriever
Gordon Setter
Great Dane
Great Pyrenees
Greater Swiss Mountain Dog
Greyhound
Harrier
Havanese
Ibizan Hound
Spitz
Irish Setter
Irish Terrier
Irish Water Spaniel
Irish Wolfhound
Italian Greyhound
Japanese Chin
Keeshond
Kerry Blue Terrier
Komondor
Kuvasz
Labrador Retriever
Lakeland Terrier
Leonberger
Lhasa Apso
Lowchen
Maltese
Manchester Terrier
Mastiff
Miniature Pinscher
Schnauzer
Neapolitan Mastiff
Newfoundland Dog
Norfolk Terrier
Norwegian Buhund
Norwegian Elkhound
Norwegian Lundehund
Norwich Terrier
Nova Scotia Duck-Tolling Retriever
Old English Sheepdog
Otterhound
Papillon
Jack Russell Terrier (Parson Russell Terrier)
Pekingese
Welsh Corgi
Petit Basset Griffon Vendeen
Pharaoh Hound
Plott Hound
Pointer
Polish Lowland Sheepdog
Pomeranian
Poodle
Podengo Portugueso
Portuguese Water Dog
Pug
Puli
Redbone Coonhound
Rhodesian Ridgeback
Rottweiler
Jack Russell Terrier
Saluki
Samoyed
Schipperke
Scottish Deerhound
Scottish Terrier Scottie
Sealyham Terrier
Shetland Sheepdog Sheltie
Shiba Inu
Shih Tzu
Siberian Husky
Silky Terrier
Skye Terrier
Smooth Fox Terrier
Wheaten Terrier
Italian Spinone
Saint Bernard St. Bernard
Staffordshire Bull Terrier
Sussex Spaniel
Swedish Vallhund
Tibetan Mastiff
Tibetan Spaniel
Tibetan Terrier
Toy Fox Terrier
Treeing Walker Coonhound
Vizsla
Weimaraner
Welsh Springer Spaniel
Welsh Terrier
West Highland White Terrier Westie
Whippet
Wire Fox Terrier
Wire-haired Pointing Griffon
Xoloitzcuintle (Mexican Hairless)
Yorkshire Terrier Yorkie
Mixed
Hound
Shepherd
White German Shepherd
Rat Terrier
Terrier
Catahoula Leopard Dog
American Pit Bull Terrier
Black Mouth Cur
Abyssinian
American Bobtail
American Curl
American Shorthair
American Wirehair
Balinese
Bengal
Birman
Bombay
British Shorthair
Burmese
Chartreux
Cornish Rex
Cymric
Devon Rex
Egyptian Mau
Exotic Shorthair
Havana Brown
Himalayan
Japanese Bobtail
Javanese
Korat
Maine Coon
Manx
Munchkin
Nebelung
Norwegian Forest Cat
Ocicat
Oriental
Persian
Ragdoll
Russian Blue
Scottish Fold
Selkirk Rex
Siamese
Siberian
Singapura
Snowshoe
Somali
Sphynx
Tonkinese
Turkish Angora
Turkish Van
Mixed
The purpose of this dog is:
*
Companionship for the applicant
Companionship for a family member
Companionship for another pet
Protection
Gift
Other:
LDRNM History
Previous LDRM Adopter?
Yes
No
*
Adopted Lapdog Name
*
Year Adopted
Adoption Request
Do you have a gender preference?
Yes
No
*
Gender Preference
Male
Female
*
Reason for gender preference
Size
5-10 lbs
10-15 lbs
15-20 lbs
20+ lbs
*
Any age preference?
No Preference
2-6 Months
7 Months - 1 Year
2-4 Years
5-6 Years
7-9 Years
10+ Years
*
What activity level best suits your home?
High Energy
Fairly Active
Calm but Playful
Couch Potato
Other
*
Other Activity Level Explained
*
Are you familiar with this particular breed/mixes? (e.g., grooming requirements, future special medical needs, etc?)
Yes
No
Will you be a first time dog owner?
Yes
No
*
Household Pet Information
Do you currently have other dogs living in your home?
Yes
No
*
List all of your current dogs with their age and breed.
Do any of your dogs have health, behavioral or dominance problems?
Yes
No
*
Please describe
Are all of your dogs Spayed/Neutered?
Yes
No
*
Are all of your dogs vaccinations up to date?
Yes
No
*
Have you ever had a pet euthanized (put to sleep), lost a pet due to an accident, had a pet that ran away, was lost, stolen or given to a shelter or a rescue?
Yes
No
*
Please Explain
*
Other Animals
Do you have OTHER animals?
Yes
No
*
List all of your other pets and how long you've had them.
*
Veterinarian Information
Do you have a veterinarian?
Yes
No
*
Phone #
*
Veterinarian Name
*
Address
*
Work Information
Are you over 21 years of age?
Yes
No
*
Are you retired?
Yes
No
*
Occupation
*
What are your hours?
*
Do you work at home?
Yes
No
*
Household Information
Do you have children permanently in your home
Yes
No
*
List all of the ages of the children in your home.
*
Have the children had or been around animals
Yes
No
*
Do you have children temporarily visit your home?
Yes
No
*
List all of the ages of the children who visit your home.
*
How many adults live in your home?
- How many adults live in your home? -
1
2
3
4+
*
Do you own or rent your home?
Own
Rent
*
Do you have written permission from your landlord to have a dog?
Yes
No
*
Landlord Name
*
What type of home do you live in?
Apartment
Town Home
Single Home
Mobile Home
Other
*
Other home:
*
Do you have a fenced yard?
Yes
No
*
Height of fence
*
ft
Type of fence:
Wood
Chain Link
Block
Vinyl
Other
*
Other fence type
*
Does your apartment have a fenced patio
Yes
No
*
What type of fenced patio?
Block
Wood
Chain Link
Other
*
Other type of patio fence
How tall are the patio walls?
*
ft
Are there any community restrictions on the number, size or breeds of dogs?
Yes
No
*
Are you within those restrictions by adopting a dog?
Yes
No
*
How will your new dog spend its days?
Indoors
Crated
Basement
Garage
Porch
Confined to a room
Fenced Yard
Loose Unfenced
Tied Outside
Dog House
Kennel Run
*
How will your new dog spend its nights?
Indoors
Your Bedroom
Crated
Basement
Garage
Porch
Confined to a room
Fenced Yard
Loose Unfenced
Tied outside
Dog House
Kennel Run
*
Additional Information
Select any issues that would prevent you from adopting a dog
Allergies
Partially Housebroken
Separation Anxiety
Fear/Aggression Toward Strangers
Extremely Shy
Vocal
Food or Toy Aggressive
Shedding vs Non-Shedding
Any Kind of Special Needs
Other
If "Other", Please explain
Are you willing to take your dog to training classes if needed?
Yes
No
*
It may take some time to find the right match for your family. Are you...
Willing to wait
In a hurry to adopt
*
What would you do with your animal should you have to move from your present address?
Take it with me
Give the dog away
Return the dog to Lapdog
Take the dog to a shelter
*
What do you do with your animals when you go on vacation?
*
Comments
Any additional comments
The Fine Print
Adoption Process.
There is
NO
obligation that the applicant must adopt the dog for whom they have applied. There is
NO
obligation by LDRNM to adopt that or any dog to the applicant. The receipt of an application for a dog is NOT an implied guarantee the applicant will be selected to adopt that dog. Adoption decisions are a subjective process driven by the foster who best knows the personality and needs of the dog and whose goal is to find the best home for the dog. You may be asked for references.
Sterilization
. Mandatory with exceptions only made due to age or health and supported by a statement by a licensed veterinarian.
Home Visit:
All adoptions require an application and a home visit by appointment. Vet records may be checked as necessary. References may be asked for. An adoption fee from $195 and up will be required at the time of completion of the Adoption Agreement. LDRNM cannot be held liable for any hazard or damages a new dog may present to known or unknown adults, children, any other animals or property. Any health issues that might arise as a result of the care provided after adoption will be the financial responsibility of the potential Adopter.
Application Certification.
All of the information I/we provided on this application is true and correct. If any of the information changes, I/we will advise you promptly.
I Accept
I do not accept
Date: 01/25/2025