Help making adoption application!

I have put an ad in our local paper about our unofficial foster dog. He is a 5 mo old BC/pit mix rescued from an unsavory relative who was way in over his head with pups. Everyone else I have found a good home for. This guy has issues--submissive/excited urination--fear issues ect. He is very friendly though and I think he will be great in a patient loving home--he just needs time. He has came a long way in our care.

Anyways I want to make up an adoption application to give everyone who enquires and then I can make my decision from there. What sorts of things should I ask--obviously about their working hours, back yard, dog experience, vet ect--but what else? Help! Thanks so much. Here is his cute self:

Key points would be

Whether they own their home or not, how long they've been there, and whether they're allowed to have Pets.
If they've had pets in the past few years, and what happened to them.
Whether they've ever surrendered an animal to a shelter, and why.
How old is everyone in the family, and do they all want a pet.
Do they have a fenced in yard.
Whether their pets (previous or current) are up to date on vaccinations, altered, and live indoors.
Veterinary reference, if possible.
How were their previous pets trained, and how will they train this pet.
Will they work to make the new pet fit into their household.
What will their expectations of the new dog be.

I think those are the most important parts to an application, you can go online and go to rescue's websites to see an example of their entire applications.

Along with what Tazwell said:
Are they looking for inside or outside pet (depending on what you are looking for I only adopt to inside homes.)
How much they think the pet will cost
Are they planning on having the pet spayed or neutered
What would they do with the pet if they could no longer keep it
Do they know of any allergies in the family
We also make sure they take the pet to the vet within 2 wks and have a stool sample checked. They have to send back a copy of the slip.

Yes, and that reminds me-- what we do with our rescue is we have the adopter sign a contract that they MUST return the pet to us if they can no longer keep it. It can't go to a friend, family, shelter, other rescue, or anything. You can try something similar to ensure he won't end up somewhere bad, and if he does, you can pursue them under breaking the contract.

Thank you for your feedback--I think these are all great ideas...I haven't had any calls yet.

he's adorable! if i didn't have five already...