Adoption Application

Applying For:

Date:*

Name of Animal:

(Optional) Seeking:

Applicant Information:

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:

Household Information:

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?*

Vacation:

How often do you go on vacation?*

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

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?*

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?

References:

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

References:*

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?*

About Me (Optional):

Tell us why you’re the right home.

About Me:

Confirmation:

By checking, I hereby certify that all information supplied by me on this application is true and complete. I recognize that any misrepresentation of that information will result in the adopted animal to be confiscated.

Applications