Pet Adoption Application

Adoption Application, Contract and Waiver
Owning a pet is a privilege, but the benefits of pet ownership come with responsibilities.

Be a responsible pet owner as per the AVMA Guidelines:
1. Commit:
  - Avoid impulsive decisions when selecting a pet.
  - Select a pet that is suited to your home and lifestyle.
  - Keep only the type and number of pets for which you can provide appropriate food, water, shelter, health care and companionship.
  - Commit to the relationship for the life of your pet(s).
  - Provide appropriate exercise and mental stimulation.
  - Properly socialize and train your pet.
2. Invest
  - Recognize that pet ownership requires an investment of time and money.
  - Make sure your pet receives preventative health care (vaccinations, parasite control, etc.), as well as care for any illnesses or injuries.
  - Budget for potential emergencies.
3. Obey
  - Clean up after your pet.
  - Obey all local ordinances, including licensing, leash requirements and noise control.
  - Do not allow your pet to stray or become feral.
4. Identify
  - Make sure your pet is properly identified (i.e., tags, microchips, or tattoos) and keep its registration up to date.
5. Limit
  - Do not contribute to our nation's pet overpopulation problem: limit your pet's reproduction through spay/neuter, containment or managed breeding.
6. Prepare
  - Prepare for an emergency or disaster, including assembling an evacuation kit.
  - Make alternate arrangements if you can no longer provide care for your pet.
  - Recognize any decline in your pet's quality of life and make timely decisions in consultation with a veterinarian.
ADOPTION APPLICATION
Your Name*

First NameLast Name
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Phone #*
Date of Birth*
mm/dd/yyyy
Driver's License Number*
Email*
example@example.com
Emergency Contact*
Are you at least 18 years of age?*

YesNo
Have you ever surrendered a personal pet to a rescue or shelter?*

YesNo
Where did you first hear about Grateful Rescue?*

Friend, Family, Co-Workergratefulrescue.orgFacebookTVEventOther
Name or Breed you are interested in adopting.*
Enter the name of the listed animal, or breed you are looking to find.
What type of pet are you looking for?*

Indoor PetOutdoor PetIndoor & Outdoor Pet
What is the purpose of adopting?*

Companionship for me/my familyCompanionship for my petsProtectionBreedingMouserGift
List animal breeds that currently live with you. *
Please list Breeds only. If you don't have a pet at this time please enter "NA" in box above.
Your Animal Clinic's Name*
Vet Name*

First NameLast Name
Vet Phone*

Area CodePhone Number
Vet Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you own or rent your home?*

OwnRent
(Answer only if you chose 'rent' above): Landlord's Phone

Area CodePhone Number
Your current household:*

Live AloneAdults OnlyFamily with Children
What is the activity level in your home?*

QuietActiveVery Active
How will you confine your pet?*

Fenced YardGarageBasementCrateLoose in HomeOutdoor KennelTie Out
If you chose "Fenced Yard," Please describe type.*

Invisible Fence4' High Chain Link Fence6' Hign Chain Link FenceWooden Privacy FenceOther
How long will your new pet be alone or crated each day?*

Never1-4 hrs a day5-8 hrs a dayMore than 8 hrs a day
Where will pet sleep at night?*

CrateOne Room in HomeLoose in HomeOutdoor KennelLoose in Fenced YardOther
Check the alternate caregiver if you are gone for extended period?*

FamilyFriendLodgingStays alone
What training methods would you use to handle potential problems?*
What will you do with this pet if you have to move?*

Take the Pet with YouRe-HomeReturn to Shelter
Would you like to receive our newsletter to keep up on events and new adoptable pets?*

YesNo
Electronic Signature Verifying Information is accurate and true.*
Conditions and Waiver

By clicking the submit button, I understand/agree:

GRATEFUL RESCUE, INC will collect information necessary to approve you for a animal adoption from our company.

The adoption process may include:
- A phone interview, personal background check, (including social media sites), rights to a home walk-through in order to approve the application.
- You grant permission for a staff member of Grateful Rescue to contact any veteranary business you have listed to provide medical history records animals you have cared for.
- You grant permission to call personal references you have provided.
- Adoption fees must be paid in full GRATEFUL RESCUE INC. at the time of the adoption.
- You indemnify and hold harmless GRATEFUL RESCUE INC. against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by an adopted animal from GRATEFUL RESCUE INC when adoption has been completed.
GRATEFUL RESCUE, INC will not disclose your personal information to anyone who is not involved in our adoption approval process.

SURRENDER AGREEMENT: I understand in the event I need to surrender the animal I have adopted from GRATEFUL RESCUE INC for any reason at any time, it must be surrendered to GRATEFUL RESCUE INC. It is your responsibility to contact GRATEFUL RESCUE at 844-728-3255 (844SAVEALL) in order to notify of the pending surrender and I agree to provide transport and pay all costs associated with delivering the animal safely to GRATEFUL RESCUE INC. (4220 N COUNTY ROAD 500 WEST, MUNCIE, INDIANA 47304).

I verify all of the above information I have provided is true and accurate.

The ADOPTION PROCESS: It is common to have several applications for a listed animal. The decision to place the animal with an applicant is based solely on the best "fit" based on many needs that each particular animal might require. If your application is approved but you are not selected at the time the animal is available it will remain in our selection process for similar animals that we take in at a later point.
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ADOPTION APPLICATION