To submit an application fill out the below information or you may download the application by clicking “Dog Application (PDF).

Please answer all questions fully and honestly. No discriminations will be made. Alchemy Acres provides an environmental adoption service to help you adopt a pet that will best fit in to your home. We make every attempt to screen our animals for health issues and behavior issues. Some problems may not present under our circumstances or may become apparent after a length of time. We make no guarantees but ask for your patience and respect toward both our animals and our volunteer staff.

If unemployed please specify how you intend to care financially for your dog’s necessities.

Please provide information for other household members at this time (please include children and temporary members/roommates or frequent visitors)

Please detail if you currently rent, lease or own your home and property where your home is located. This section also applies to those who must accomidate a home ownership association or like entity.

Please answer the following inquiries

  • Dog Adoption Application
  • Applicant Information
  • Employer Informaiton
  • Household Information
  • Home Ownership Information
  • Questionnaire

Name of Dog Requesting or Description of the type of dog(s) you would be interested in.

Name of Dog Requesting

Applicant Information (Must be 21 years of age or older) A Photo ID will need to be provided at time of visit.

Applicant Full Name

Street Address

Mailing Address (or SAME)

City, State, Zip

County of Residence

Primary Phone Number

Secondary Phone Number

Email Address

Date of Birth

Provide a VALID Photo ID Number and State

Employer Information

Name of person(s) in house hold with main income



City, State, Zip Code

Work Phone Number (with extension)

Please List Person name, age, relationship to the applicant

Please indicate the type of housing and environment the pet will have.

Home Type

Area surrounding the home

Enclosure available to pet

If there is fencing what type and how tall?

Describe the ownership information

Name of homeowner.

How long have you lived at this address?

Name on title/deed

Name of complex or association

County, City, State, Zip Code

Phone Number of owner or management

Is there a pet deposit, if so has it been paid?

Is there a monthly fee for pets?

Are you aware of any rules of limitations for pets set by a landlord?

Have you notified your landowner that you are seeking a pet?


Would you allow an Alchemy Representative to visit your home?

Are there any active military members living in the household?

How many times have you moved in the past 10 years?

If you move after the pet adoption will your pet go with you?

Have you ever lived in a home that did not allow pets?

Does anyone in your household smoke? (This question is asked to consider the animals that may have a pre-existing health concern).

How would you describe your home environment with a pet?

Are you able to provide a permanent home for this dog's life (please consider longevity, financial care and medical necessities)

Are there any major illnesses in the home that may be affected by the presence of a new pet (i.e. allergies, breathing conditions, physical challenges).

Do you foresee any major changes in the next 15 years?

Specify any reason you wish to adopt a pet.

Mark any reason you would justify to give up a pet. Most pets need an acclimation period when entering a home to adjust. Some pets may develop issues over time. This question applies to what you feel you are unable to adapt to or handle?

Please describe an exercise plan for your new dog

Please describe your plan for housetraining and schedule for toilet duties

Do you plan on keeping a collar with ID on your Pet?

Approximately how often or how many hours will the pet(s) be left alone on a traditional day?

Where will the dog(s) stay on a typical day with a family member at home?

Where will the dog(s) stay when home alone?

Would you be willing to adopt a pet with a pre-existing Medical need?

Most pets develop medical needs as they age, do you feel prepared to financially and physically aid the pet?

Are you willing to care for a pet that has pre-existing behavioral issues like anxiety, extra training needs or possession issues?

Most pets from a shelter will exhibit some forms of anxiety during their acclimation period which will most often resolve. If an issue like this arises or another issue, do you feel capable of caring for the dog?

Have you had any pets or found any other animal that has died of an unknown cause potentially being ParvoVirus, Distemper or another Zoonotic Disease on your property?

Have you ever had to have an animal euthanized (put to sleep)? If Yes, please elaborate why.

Have you ever surrendered an animal to a shelter or pound? If yes, please elaborate.

Have you ever given a pet away to another home? If yes, please elaborate.

Will you agree not to surrender the pet you adopt from Alchemy Acres to anyone other than Alchemy Acres should the situation arise in the future?

Have you ever adopted from Alchemy Acres? If yes, who and when did you adopt?

How did you hear about Alchemy Acres?