Adoption Application

Name of pet are you interested in adopting?

Please provide the following contact information:

Name
Street Address
City
State
Zip Code
Work Phone
Home Phone
E-mail

Please list all people living in the household...include names, ages and relationship to applicant.

Do you own your current home?

yes
no

What type of home are you currently living in? (Note -living in an apartment, mobile home or condo WILL NOT disqualify you for adopting a pet, as long as you are still able to meet that pets individual needs.)

house
apartment
condo
mobile home

IF RENTING, please provide your landlords name, address and phone number.

IF RENTING, please describe any restrictions on pets....size, breed, (declawed cats), etc.

Is everyone in the household in agreement about adopting this pet?

yes
no
haven't discussed
surprise for household member

Who will be this pets primary caretaker?

Where will your new pet live?

house
yard
both

If your new pet will be both in the house and outdoors, please describe what kind of outdoor shelter is available (barn, shed, dog run, dog house, etc)

Is your yard securely fenced? Please describe size and type of fencing.

If you are applying to adopt a dog, how will the dog be let out to relieve itself? Select any of the following options that apply:

fenced yard
leash walked
free roam
tie out cable
kennel run
loose w/ supervision
      other (explain below)

Where will your new pet stay when you are away?

How many hours a day do you anticipate your pet being home alone?

Where will your new pet sleep at night?

Are you familiar with crate training? Do you intend to use a crate? Do you currently have one?

Please list ALL pets currently living in your home. Include name, breed, age, and how long you have had them.

Please list all pets that you have previously owned. Include name, breed, and why you no longer have them.

Are your current pets spayed/neutered, current on vaccinations and if dogs, heartworm tested and on prevention?

yes
no

If the answer to the previous question for any pet was no, please explain.

If you are applying for a cat, will the cat be allowed outdoors?

Never Yes Overnight As it wishes

If you are applying for a cat, do you intend to declaw? 

Yes No Undecided

Please provide the following Veterinarian information. (NOTE, some vets require that you call and authorize them to talk to us)

Designer HandbagsChristian Louboutin Pumpsmulberry handbags ukchanel handbags replicatory burch flatsLouis Vuitton Handbagsonitsuka tiger by asicsdesigner handbags ukhandbags ukchanel bags

Name
Clinic/Hospital Name
Street Address
City
State
Zip Code
Phone
FAX

If you have used any other veterinarian's please list names and phone numbers below. Include which pets they treated.

What interested/attracted you to the pet that you are applying to adopt?

Do you have any experience with this breed? (if yes, please explain) Any questions or concerns regarding this breed?

If you do not currently have children, if in the future you do, what affect will this have on your pet?

What are possible scenarios that would cause you to give up a pet?

How will you handle any destructive behaviors?  (Examples:  digging, housebreaking issues, chewing, cats scratching, litterbox issues, etc)

Please share any additional comments or considerations that you would like us to know:

Have you adopted at pet before? Select any of the following options that apply:

NO
Rescue
Animal Shelter
Humane Society

If you have adopted a pet previously, please tell us from where.

Please provide two personal references. Include name, address and phone number for each

The information provided in this application (in its entirety) is true to the best of my knowledge as of the date on this application. I agree that either my signature on this copy or submission of this form by email will constitute a legally signed document. (enter your name here to 'sign’ on the internet or sign below if done on hard copy):

 Name:

 Date: