Please bring completed application in person to the CVHS.

262 County Farm Cross Road
Dover, NH 03820
(603) 749-5322
Matchmaker, matchmaker, find me a DOG! SHELTER HOURS
Mon, Tue, & Wed - Closed
Thurs - noon - 4pm
Fri & Sat - noon - 5pm
Sun - noon - 4pm


My Preferences

I like dogs that are:
Small Medium Large Any size

The breeds or mixes I like best are:

 Please describe the temperament and activity level you are looking for in a dog. Check all that apply.
Athletic/high-energy Outdoor dog Lap dog
Mellow Very affectionate Quiet

When it comes to relating to dogs, I tend to be more:
strict, demanding, a real leader (the dog must sit for a cookie), or

lenient, a little wishy-washy, easily coerced by the dog (the dog looks cute so she/he gets the cookie without performing the sit)

Someone in my home is nervous or unsure of dogs:
very (e.g. bitten as a child)
some (no experience with dogs)

About Me and My Household

I share my home with ___ adults and ___ children.
Ages of children:

I have children that visit or live next door.

 I have ___ indoor cat(s), ___ in/out cat(s), ___ dog(s), and these other pets and livestock:

 The noise/activity level in my home is usually
low medium high

When it comes to keeping a clean and tidy house I am
very particular particular easy going

I need a dog that will tolerate being alone ___ hours/day
weekends for frequent short trips

I'd enjoy brushing or grooming my dog:
rarely occasionally weekly daily

I would enjoy taking my dog in the car:
daily frequently once in a while


I prefer a dog whose energy level is:
high medium low

I prefer a dog that:

will enjoy walking with me on a leash
will enjoy walking with me on or off the leash
will run, jog, or hike with me
will exercise him/herself in our yard
required only enough exercise to do his/her "business"
will enjoy living outside


My ideal dog would:

 Bad doggie habits that I just can't tolerate are:

 It may take a new pet up to 2 months to adjust to a new home. Are you willing to devote this time?

 Please tell us anything else you would like us to know about you or the dog you're looking for.

Adoption Application for a Dog
Name (first, middle initial, last)


Maiden Name


Date of Birth


Home Phone




Spouse Name


Spouse D.O.B.


Work Phone


  Do you:
___ Own
___ Rent
If You Rent - Landlord's Name


  Landlord's Phone


How Long at Current Address?


If Less Than One Year, Please Show Previous Address


Are You:
Working Attending School
Retired Homemaker
Employer's Name


Spouse or Partner's Employer's Name


Employer's Phone


Spouse or Partner's Employer's Phone


What types of pets have you owned in the past five years?
Name Breed/Type Age Sex Altered Still Own Kept Where If no, what happened to this pet
Who is/has been your veterinarian?


Ever Brought Animal to Shelter?
Yes No


 Please check any areas you would like to discuss with an adoption counselor:
What to feed your dog and how often Crate training
Introducing your new dog to other pets House training
Introducing your new dog to children and other family members Exercising


 How will you handle the following?

Where will you keep your dog during the day, at night, or when you're not home?

 If you have to move?

 How will you care for your pet when you're on vacation or business trips?

 How will you handle bad habits such as marking, jumping up, nipping, barking, chewing, digging?

 Please list two personal references:













 I certify that the information I have given is true, and I authorize CVHS to contact veterinarians, landlords, and references to investigate all statements in this application, and to do follow-up property checks.




Date: ID#
Adoption Counselor: Approved subject to proof of Date rec'd


Landlord Verification: ID, age, or address  
Property check required Landlord OK  
Vet Report: For animals at home
Description of animal requested:


Current vaccinations  

Follow up: (CVHS USE ONLY)