Please submit application & agreement via e-mail by clicking the above "submit application" button or print the application and mail it to (Note:  If you are mailing your application, please notify us). :

-Noah's Friends Animal Sanctuary

PO Box 238

Orange Cove, CA 93646

  Noahs Friends Animal Sanctuary   Adoption Application & Agreement   *Loving Homes for Loving Dogs* IT IS IMPORTANT THAT YOU FILL OUT THE APPLICATION COMPLETELY. IF YOU FEEL THAT A QUESTION IS NOT APPLICABLE TO YOU, PLEASE PUT "NOT APPLICABLE." PART I: 1.  Name /Home Address & Phone Number: 2.  Work Address & Phone Number: 3.  E-Mail Address: 4.  If applicable, Spouse's Work Address & Phone Number: 5.  Name of Dog(s) You Would Like To Adopt: ___________________________ 6.  How did you hear about this particular dog(s)? ________Petfinder.org _______Pets911________Noah's Friends Web Site_______Breed Rescue Site________Other (please explain ;-).

PART TWO: 1.  Do you rent or own your home? _______ Own _________ Rent . 2.  Do you have the landlord’s permission to keep a dog(s)? _____ Yes. ______ No _____ Not Sure. 3.  Landlord’s Name & Phone Number:  ____________________. 4.  Do you live in  a house or apartment? ________ House ________ Apartment _______Trailer _______ If Other (please describe) _____________________. 5.  How long have you lived at this address? ___________________. 6.  Do you have a fenced yard? ______ Yes ________ No. 7.  Do you have a separate kennel run? _________ .

PART THREE 1.  Number of adults in household? ________. 2.  Number of children in household? ________. 3.  If you do not have children in your home, will the dog(s) have contact with children of friends, relatives, etc.. _________. 4.  Do you have livestock or farm animals? __________. 5.  Do you own other dogs? ___________. If so, how many? ______________. 6.  Do you own a cat or cats? ____________. If so, how many? ____________. 7.  Which of your pets are spayed or neutered? _____________. 8.  If some or all of your pets are NOT spayed or neutered, why not? _________________________. 9.  Give breed, sex and age of each pet in your care ____________________________________________________________. 10.  Do you own any other type of animals? _____________. 11.  If so, what kinds of other animals ? __________________________. 12.  How long did you have your last dog? _________________. If you owned your last dog for less than a dog’s normal life span, 10-15 years, what happened? _____________. 13.  Name & Phone Number of Your Regular Veterinarian __________________________________. 14.  Do you grant a representative of  Noah’s Friends Animal Sanctuary permission to contact your veterinarian as a means of reference ? ____ Yes ______ No.

PART FOUR 1.  Have you owned a _____________ or similar breed type before? ____ Yes. _____ No. 2.   What are your plans for this dog? (Please Check All That Apply): ________Member of the Family. _____ Pet. ________ Best Friend.  ______Guard Dog. _______Herding Dog. _______ Obedience/Agility. _______ Therapy Dog. ____ Hunting. ______Other. 3.**If you chose “Other,” please describe __________________________. 4.  Do you agree to consistently provide suitable dog food and fresh water for the dog(s)? _______ Yes _______ No. 5.  What do you believe to be the most effective training methods to train dogs? (Please Please Check All That Apply): _________ Food Treats. __________ Praise. ________ Physical Punishment, On Certain Occasions  _________ Obedience School. __________ Positive Reinforcement for the Behavior You WANT. 6.  If this dog(s)  is not house trained, how will you train him or her to not go to the bathroom in the house? (Please Check All That Apply) ________ Crate Training __________ Carefully Watching and Anticipating his/her Need to Go to The Bathroom and sending him/her Outside and Praising When he/she goes to the bathroom. __________ Rubbing his/her nose in its “mess”  and then sending him/her promptly outside. __________ I have no idea, but I’d like some information on the subject. 7.  How many hours a day, on average, will this dog(s) spend alone? _______________. 8.  Where will the dog(s) spend the night? ________________. 9.  Will this dog(s) be primarily an outside or inside dog(s)? _________________. 10.  When you go out of town, who will take care of this dog(s)? _______________________. 11.  If you by chance move in the next 10-15 years, what will you do with the dog(s)? ___________ Give the dog(s) to a friend. __________ Take the dog(s) With us no matter what! __________ Give the dog(s) back to Noah’s Friends Animal Sanctuary. ______ Take the dog(s) to the nearest animal shelter to find a new home. 14.  Can you imagine any circumstance that would cause you to feel that this dog(s) would no longer be welcome at your home? _______ Yes. Please explain______________________________. _______ No. 13.  At Noah's Friends, we are looking for great homes for all of the pets in our care.  In what way would you provide a particularly good home for this dog(s)? Please explain.

PART FIVE: 1.  Do you understand that Noah’s Friends Animal Sanctuary REQUIRES that this dog(s) be spayed/neutered? ________ Yes. ___________ No. 2.  Do you agree that if for some reason this dog is NOT already spayed or neutered prior to adoption,  that he or she MUST be spayed or neutered within two months of the adoption date?  _____ Yes. _______ No. 3.  Do you understand that you MUST send a copy of the spay or neuter certificate for this dog(s)  within two months of possession of this dog(s)  to Noah’s Friends Animal Sanctuary? ______ Yes. ________ No. 4.  Do you agree to license this dog as required by city law,  AND  provide it with regular (at least once per year for a routine checkup) health care through a licensed veterinarian? ______ Yes. ________ No. 5.  Do you agree to provide a properly fitted collar and  ID tag with your current address and phone number ? _________Yes. ________ No. 6.  Do you understand that it is MANDATORY that you contact Noah’s Friends Animal Sanctuary FIRST to make arrangements for us to pick up the dog, at ANY TIME during the natural life span of this dog , if you are no longer able to keep him or her? _______ Yes. _________ No.

PART SIX 1.  Do you understand that if the above requirements are NOT met, that Noah’s Friends Animal Sanctuary has the RIGHT to RECLAIM the dog(s) ? _______ Yes ________ No. 2.  Would you be willing to allow a representative from Noah’s Friends Animal Sanctuary to visit your home by appointment? ______ Yes ______ No. 3.  If not, please explain _________________________. 4.  Do you agree to pay the non-refundable, $120.00  Adoption Fee for each dog(s), (name of dog(s)_____________________ you might be adopting? _______ Yes. ________ No. 5.  Do you agree that upon adoption of: _______________ . that Noah’s Friends Animal Sanctuary CANNOT be held responsible for the above mentioned dog(s) temperament or health? _____ Yes. ______ No. 6.  By signing below, I declare all of the above information to be true and complete to the best of my knowledge: Printed Full Name: ____________________________. Signature: _____________________________.    Date:  ________________. (Hand-written signature(s)  required prior to adoption) Spouse’s Printed Full Name: _________________________. Spouse’s Signature: ____________________________. Date: _____________. Printed Name of Qualified Representative of Noah’s Friends Animal Sanctuary: ______________________________. Signature of Qualified Representative of Noah’s Friends Animal Sanctuary: _______________________________.    Date