GREYHOUND FRIENDS OF NORTH CAROLINA, INC.

2908 Oak Ridge Road, Oak Ridge, NC 27310

Phone: (336) 643-0233

Fax:  (336) 644-2703

Email:  adopt@greyhoundfriends.com

ADOPTION APPLICATION

□Just Looking                □ Ready to adopt                                                                                                 □Application Fee Paid

____________________________               ______________________           _____________________

Applicant Name                                                   Spouse/Significant Other                 Length of Relationship

__________________       ____________________               ___________________________________        

Profession                            Profession                                          Email Address

________________________________________________________________________

Address

______________________                __________                ________                 ____________________________

City                                                         State                       Zip Code      Best Time to Call                         

______________________                __________________________             ____________________________

Home Phone (Include area code)      Work Phone (Include area code)                Cell Phone (Include area code)           

May we contact you at work, if necessary?  Y / N

What is your daily schedule like & how much time can you commit daily to spending with this pet? ________

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Please list the names and ages of all children in the household:

Does anyone in your home have allergies or any other health condition that will interfere with your providing proper care for this greyhound?  Y  /  N  :  If yes, what type of condition?  ____________________________

What experience do you have with dogs? ____________________________________________________

Why have you chosen a greyhound to adopt?  ________________________________________________

Who will be primarily responsible for the care and training  of this dog? _____________________________

How much travel does your work entail? _____________________________________________________

Do you understand that your greyhound MUST live inside?  Y  /  N  : If your greyhound is alone all day, where do you intend to leave it?  (Crated, Loose, Fenced, Other?) _________________________________

Are you financially able to accept immediate & full responsibility of ownership for the remaining life of the greyhound that you have chosen to adopt ?  Y  /  N

Please note:  The initial cost to adopt a greyhound is $295.00. (effective 4/1/08) The approximate monthly cost for proper care of a greyhound is $75.00 (food, vaccines, dental cleaning, heartworm & flea  preventative, and other costs).  The average greyhound lifespan can range between 12-15 years.

Do you rent □ / own □? In what type of dwelling do you presently live?

□ Single Family Home     □ Apartment (□ 1BD / □ 2BD)                        □ Condominium     

□ Mobile Home                    □ Other Multi-Family Dwelling                                □ Other

Landlord data required, if you lease residence (We must have proof of landlord’s approval prior to adoption)

Name: ________________________________________________________________________________

Address: ______________________________________________                Phone: ______________________

Do you have a fenced back yard?  Y  /  N :    If yes, what type, size, & area? _________________________

If no, are you willing to leash-walk your greyhound 3-4 times daily for necessary functions and exercise? Y/N

Please indicate all other dogs and cats in the household:

List all other pets (be specific): ____________________________________________________________

What became of all the pets that you have owned in the past 10 years (be specific) : __________________ ______________________________________________________________________________________

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Mark all reasons you consider valid  for relinquishing  ownership of a  dog?  Barking □ Whining, Crying □ Chewing □ Housebreaking Problems □ Destructive Behavior □ Digging □ Biting □ Too Rough with Children □ Expense □ Moving □ Other Major Lifestyle Changes □ (be specific) _______________________________

As a reference, please list your veterinarian’s name, clinic, and telephone number (if applicable):

Name: ________________________________________________________________________________

Address:  _________________________________                Phone: ____________________________________

List (3) references, (2) of which are not related to you, a telephone number, and when they can be reached:

______________________________________________________________________________________

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Are you, or have you been a volunteer of, or a previous adopter of a greyhound from GFNC?  If so, when:  ______________________________________________________________________________________

Have you worked with any other animal welfare organization in the past 6 months to pursue adopting a greyhound or any other pet? Y  /  N:  If yes, which group and when?________________________________

Would you consider adopting a senior (7+years) or a special needs greyhound?  Y  /  N /  Maybe

Micro Chip $30 additional charge at time of Spay/Neuter?   Yes / No

I certify that all statements I have made in this application are true and correct.  I agree to abide by the requirements set forth in the adoption contract.  I authorize a GFNC volunteer to investigate my answers herein, and I understand that my application is pending the outcome of that investigation.

 ____________________________________________________                ____________________________

Signature                                                                                                              Date

____________________________________________________                ____________________________

Signature                                                                                                              Date

Do not write below this line

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