Adoption Application

Adoption Application
We are happy that you have come to us to adopt a new pet. We hope that we can be of service to you. To help ensure that the pet you want will be best suited to you, your home and lifestyle, and that the pet will be placed in an environment compatible with its needs, we ask for your cooperation in filling out this application. We hope you will agree that the pet’s welfare MUST be our foremost consideration. Upon completion of this application, a staff member will discuss the adoption with you and answer any questions you might have. We ask for your patience and cooperation. Thank you.
Name of the pet you are interested in Adopting
Pets Name*
Personal Information
Full Name*

PrefixFirst NameLast NameSuffix
Spouse Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Your Employer*
Work Number*

Area CodePhone Number
Spouce's Employer
Spouce's Phone Number

Area CodePhone Number
Your Age*
Your Spouce's Age
Personal Questions
Are you expecting a child or planning a family?

YesNo
Does your job require frequent out of town travel?

YesNo
Are you subject to relocation?

YesNo
Are you a student?

YesNo
Are you in the military?

YesNo
Family Information
How many family members live in your home, including yourself?
List the ages of the family members living in your home:
Besides your immediate family, do others reside in your home?

YesNo
List the ages of the others residing in your home:
Home Information
Do you own or rent?

OwnRent
If you rent, please provide name of your landlord:

PrefixFirst NameLast Name
Please provide number for your landlord:

Area CodePhone Number
How long have you lived at your current address?
Please describe your neighborhood:
Does your home have a yard?

YesNo
If not, explain how and where you will allow a dog to excercise and relieve itself?
Do you have a fenced in yard?

YesNoN/A
If yes, please describe your yard.
How tall is your fence?
How far from the road is your fenced area:
Other Pet Information
Do you have other pets at this time?

YesNo
If yes, please tell us what pet(s) you have.
If yes, are they spayed or neutered?

YesNo
If yes, are they currently on heart worm preventative?

YesNo
If yes, are they indoors or outdoors?

IndoorsOutdoors
Other:
Please describe in detail the perfect pet for you, including age, sex and temperament:
Do your pets get along with (tolerate) other animals?

YesNoN/A
If no, please explain:
Have you fostered a pet before?

YesNo
If yes, please describe the pet:
Do you prefer a pet that will be primarily indoors or outdoors?

IndoorsOutdoors
Please describe where the pet will stay when you are at home:
Please describe where the pet will stay when you are away:
Please describe where the pet will sleep at night:
How many hours per day will the pet be alone?
Do you have a crate?

YesNo
Do you plan to use a crate? Why or why no?
If yes, how many hours per day will the pet be crated?
What kinds of solutions would you be willing to try if housebreaking accidents occured?

CrateLeave outsideNone, I would need to return the pet
Other (specify):
Veterinarian Information
Many veterinarians will not release information to us without your permission. Please let your vet know that someone from the Biscuit Foundation will be calling them and that it is OK to release information to us.

Please provide us with your current veterinarian information (required):
Veterinarians Name*

PrefixFirst NameLast Name
Veterinarians Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Veterinarians Number*

Area CodePhone Number
I spoke with my Veterinarian:*

MonthDayYear
I spoke with:*

First NameLast Name
References
Please provide three references not related to you:
Reference # 1: Name*

PrefixFirst NameLast Name
Reference # 1: Number*

Area CodePhone Number
Reference # 2: Name*

PrefixFirst NameLast Name
Reference # 2: Number*

Area CodePhone Number
Reference # 3: Name

First NameLast Name
Reference # 3: Number

Area CodePhone Number
I certify that all statements made by me on this adoption application are true and correct.
Enter the message as it's shown*
Should be Empty:

Adoption Application

Name of the pet you are interested in Adopting

Personal Information

Personal Questions

Family Information

Home Information

Other Pet Information

Veterinarian Information

References