* Required fields

Applicant*

Co-Applicant

Street Address*

City*

State*

Zip Code*

Email Address*

Phone*

Are there any other pets in the home? Please list number and type of animal:*

Why do you want to adopt a retired racing greyhound?*

How did you hear about CGA?

What is the total number of people living in your home?*

How many children live in your home?*
Children's ages

How many hours per day will your greyhound be left alone?*

Does anyone in the household have special needs?

Do you own or rent your home?*
Please Select Own Rent

What type of home do you live in?*
Please Select House Mobile Home Condo Apartment

If you live in an apartment, condo or have a homeowners association, do you have permission for a dog over 50 pounds? Yes No

Landlord's Name

Landlords Address

Do you have a completely fenced in yard?* Yes No

We will contact your veterinarian for a reference; please contact his/her office and authorize them to speak with us concerning your adoption. We suggest that you talk to your veterinarian about your decision to adopt a retired racing greyhound. If you do not have pets, please supply the name of another reference who is not related to you.

Veterinarian/Reference (Please provide name, address and phone)

I am interested in adopting a retired racing greyhound and certify that I have answered all questions honestly and to the best of my ability. I understand that greyhounds are sight hounds and must be kept on a leash or in a secure, fully-fenced area when outside. I also understand that greyhounds are strictly house dogs and are not suited to outside living. If I adopt a greyhound and am unable to keep the dog for any reason I will return the dog to Connecticut Greyhound Adoption~GPA.

Please re-enter your name to verify you have read and agree to abide by the agreement above.

Name*

CGA/GPA reserves the right to deny an adoption at any point during the process.