Adopt A Pal Canine Adoption Application

Canine Adoption Application

Thank you for considering adopting from Adopt A Pal Animal Rescue.

This is NOT a commitment or contract to adopt. It is for informational use only.

We are a 100% volunteer based organization so please allow us five business days to review your application.

Our adoption process:

Application

Background Check

Home owner/HOA/Landlord verification

Vet Reference

Personal References

Home visit

What is the name of the animal(s) you are interested in?*

Why are you interested in this/these particular animal(s)?

If this animal is unavailable, could you please list what you are looking for?

Name*

First NameLast Name

Do you go by any other name or aliases other than your legal name?

Date of Birth:*

Date

Email*

example@example.com

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name of county of the state that you live in:*

Do you own or rent your home?*

Please list landlord name and phone number if applicable, or HOA:

Height of fence?

Do you have plans to move in the near future? If so please list new address.

Employer, position and years with the company:*

Full Names, birthdates, and relationship of all household members:*

How often do you travel for business or pleasure?*

What will you do with your pet when you're traveling?*

How will you entertain/exercise your pet?*

How many hours a day will your pet be left alone?*

Where will your pet be kept when it is home alone?*

Where will your pet be at night?*

Do you have a dog door?*

Animal History. Please list other pets in the home, name, species, breed, age, sex, alter status (spay or neuter), current on vaccinations and any medical conditions they may have. Please also list past pets you've in the past five years.*

Rows	Name	Species	Breed	Age	Gender	Spay/Neuter	Up-to-date on vaccinations	Medical conditions	Living Y/N
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

What is the name and telephone number of the veterinarian you use?*

Are you financially prepared for unforeseen medical expenses?*

Please list any pets you have had in the past five years that are no longer in your home. Please explain the circumstances.

YesNo

What steps would be taken if your newly adopted animal begins to exhibit undesirable behaviors after adoption?*

Will you invest in training for this animal?*

Please list three personal references. Please note that only one personal reference may be a relative.

Personal Reference #1*

First NameLast Name

Phone Number*

Area CodePhone Number

Personal Reference #2*

First NameLast Name

Phone Number*

Area CodePhone Number

Personal Reference #3*

First NameLast Name

Phone Number*

Area CodePhone Number

By sending this electronically, I acknowledge that I have completely read this application for adoption and comprehend it fully. I also agree to the following.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the denial of the application for adoption.

I understand that Adopt A Pal has the right to refuse any request for adoption.

I give permission to Adopt A Pal to share information about me that may be obtained during interviews, reference checks or home visits with other humane organizations

If I am chosen for adoption I promise to return animal to Adopt A Pal if in the event that I need to rehome animal.

Date*

Date

Your name*

Signature

Thank you for completing our adoption application. We will be in touch as soon as it has been reviewed. Thank you.