Adoption Application

Date: Applicant's Name: Street Address: City, State, Zip: Phone Number: Email: Name of the pet you are applying for: Why do you want to adopt this pet? Name and number of your veterinarian: If you have never had a pet before please list the vet that you will likely use. How many people in household? Number of adults & their ages: Number of children & their ages? Who will be the primary caretaker of this pet? Is there anyone in the home who may be adversely affected by dogs/cats (allergies, etc.)? Do all members of household want to adopt this pet? What type of home do you live in? Do you own your home? If no, please provide landlord's contact information: How long have you lived at your present location? Do you anticipate moving in the near future? If yes, explain. Do you have a fenced in yard? If yes, describe? Have you had experience with rescued pets before? If yes, describe? Please list the pets in household now, age, breed, & sex: Are they vaccinated? Spayed/neutered? On heartworm prevention? Tell us about any pets you have owned in the past 10 years: What happened to these pets? Are you aware that a rescued pet may not be fully housetrained? Yes No Are you willing and able to housetrain the pet? Yes No If a behavioral problem appears, what steps will you take to work on it? If applicable (Dogs), would you be willing to take the pet to obedience training? Yes No If applicable (Dogs), how do you plan to exercise the pet? How many hours a day will this pet spend without humans? If applicable (Dogs), if more than 8 hours, do you have someone to take the pet out? Explain. When no one is home where will the pet be kept? When you are home, where will the pet be kept? Under what circumstances might you decide NOT to keep the pet (new baby, divorce, new job, moving, problems with pet's health, problems with pet's behavior, if other please specify?) Thank you so much for your interest in adopting a rescued pet...they're the best!