NEW - Adoption Application for Dogs Step 1 of 5 20% My Contact InformationDate* I wish to adopt from the following location:*AntigonishCape BretonDartmouthColchesterHantsKingsLa BaieLunenburgPictouQueensYarmouthI am submitting this application because...*I am ready to adopt now **PLEASE NOTE WE DO NOT ACCEPT PREAPPROVAL APPLICATIONS. **The name of the dog I wish to adopt is:Only submit this application if you are ready to adopt now and have a dog in mind. View the dogs available for adoption on our website here: http://www.novascotiaspca.ca/adoptions/ Submitting this application does NOT reserve the dog for you, or reserve your spot in line for a particular dog. Contact your local shelter or foster directly for information on how an adopter for a dog is selectedName* First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone*Email* Please add me to your email list for SPCA updates:* Yes No About My HomeNumber of adults in my home*18 years of age or olderName of all adults in my home:*Please include last names if it differs from the last name of applicant.Number of children in my home*Ages of children in the homePlease list ages of each child in the home. I have the following pets in my home:*No other petsDogCatDog #1 Dog Name Age Breed Sex (M/F) Please fill in the above information for EACH dog(s) in your householdIs the above mentioned dog spayed or neutered?YesNoDog #2 Dog Name Age Breed Sex (M/F) Please fill in the above information for EACH dog(s) in your householdIs the above mentioned dog spayed or neutered?YesNoDog #3 Dog Name Age Breed Sex (M/F) Please fill in the above information for EACH dog(s) in your householdIs the above mentioned dog spayed or neutered?YesNoDog #4 Dog Name Age Breed Sex (M/F) Please fill in the above information for EACH dog(s) in your householdIs the above mentioned dog spayed or neutered?YesNo Life With My New DogMy experience with dogs...*I am a first time dog ownerI am an experienced dog ownerMy new dog will be kept...*Primarily IndoorsIndoors and OutdoorsOutdoors OnlyMy new dog will be left home alone for this many hours each day:*I would like to include my dog in the following activites (e.g. Hiking)* Dog PreferencesLet us know what you're looking for in a puppy or dog so we can find you a perfect match...* Puppy Young Adult Adult Senior No Preference The ideal size (as an adult) would be:* Extra small (less than 15 lbs) Small (15-25 lbs) Medium (25-50lbs) Large (50-75lbs) Extra Large (75+lbs) Gender* Male Female No Preference Energy Level* Low Medium High No Preference Coat (Hair) Length* Short Medium Long No Preference I would prefer the following breeds and/or breed mixes:Things I would like to know more about:*Supplies I will need to get startedIntroducing the new dog to my current petsIntroducing the new dog to childrenHouse trainingCrate trainingGroomingTraining techniquesDog trainers and obedience classes in my areaAnnual veterinary care requirements and costsVeterinarians in my areaDealing with unwanted behaviorsFood and nutritionThe Nova Scotia SPCA can provide you with information on a variety of animal care and behavioral issues. Let us know if there is anything you's like to learn more about! My ReferencesPlease provide two references whom we can contact. One of the two references cannot be a family member. References must not reside in the same household of you.Reference #1* First Last Relationship*FriendFamily MemberCo-Worker or BossVeterinarianContact Number*Alternate Contact NumberReference #2* First Last Relationship*FriendFamily Member*Co-Worker or BossVeterinarian* only one of your references can be a family member Contact Number*Alternate Contact NumberReference #3* First Last Relationship*FriendFamily Member*Co-Worker or BossVeterinarian* only one of your references can be a family member Contact Number*If one of the references above is my veterinarian, I give my consent for you to contact the veterinarian listed and for my vet records to be released to The Nova Scotia SPCAYesNoConsentBy ticking 'YES' you are hereby verifying that all information provided in this form is truthful and correct. You also permit The Nova Scotia SPCA to contact your references with the information you've provided.*YesPLEASE NOTE - If you rent and are currently prohibited from owning a dog, your consent to this form acknowledges that the Nova Scotia SPCA and its branches accepts no responsibility and your adoption fee will not be refunded if you need to return the puppy or dog to one of our shelters.