Adoption Application

Step 1 / 10

Applying For

Date*

Name of Animal*

Seeking (Optional)

Step 2 / 10

Applicant

Full Name*

Address*

City*

Phone Number*

Email Address*

Best time to reach you*

Age*

Place of Employment

Address of Place of Employment

How Long in Present Job

Phone Number of Place of Employment

Step 3 / 10

Household

Full How long at your present address?*

Do you own your home?*

YesNo

Are you planning to move within the next year?*

YesNo

If you decide to move in the future, what will you do with your companion animal?*

What provisions have you made for your companion animal in the event of your illness or death?*

How many adults/children are in your home? Ages?*

Are all members of your household aware of your plans to adopt an animal?*

Are any members of your household allergic to animals?*

Where will your animal be during the day hours while at work?*

Where will your companion animal sleep?*

How many hours will your companion animal be alone?*

Who will be responsible for the animal?*

Does anyone in your household smoke?*

Step 4 / 10

Vacation

How often do you go on vacation?*

Who will care for your companion animal when you go on vacation?*

Step 5 / 10

Other Animals

Do you have cats?*

YesNo

Do the cats live strictly indoors?

Are the cats declawed?

Do you have dogs?*

YesNo

If yes, how many? Breed?

How old are your other dogs?

What are their play styles?

Any specific behaviors (ex. Resource guarding, territorial, leash reactivity, etc.)?

Other animals?*

YesNo

Are all animals in your household spayed/neutered?*

Where will your pet be during the day?*

Where will your pet be at night?*

Step 6 / 10

Vet Care

Name of Veterinarian*

Veterinarian Phone Number*

If no companion animals at this time, have you had any in the past 8 years?*

YesNo

If yes, what happened to them?

Step 7 / 10

References

Please list 5 people other than family who you have known at least 2 years and their contact information.*

Step 8 / 10

Additional Questions

Have you adopted an animal before?*

YesNo

What type of personality are you looking for?

Have you ever had a special needs animal before?*

YesNo

If yes, describe*

If necessary, how will you discipline the animal?*

Is your backyard securely fenced?*

YesNo

How tall is your fence?*

Step 9 / 10

About Me (Optional)

Tell us why you’re the right home

Step 10 / 10

Agreement

Adoption Application

Thank you!