E-ADOPT APP

Electronic Adoption Application

www.elmorespca.org info@elmorespca.org 518.353.7755
Date*

MonthDayYear
Date
Name of animal you are interested in adopting.
Second choice, if above animal not available.
Tell us about your adoption preferences.
Species Desired

DogCatOther
Describe, if "Other" selected
Breed(s)
Gender

MaleFemaleNo preference
Age range
Acceptable size/weight
Any color(s) preference
Any coat length preference
Traits most important to you:
Any additional information/ comments

EMPLOYMENT STATUS
Are you currently employed?*

YesNo
If yes, place of employment
If no, do have a source of income needed to provide proper nutrition and veterinary care for this pet?

YesNo

REFERENCE INFORMATION
References provided cannot live in the same household as applicant. Two references are required. A space for a third optional reference has been provided.

Many times the adoption processing gets delayed because we are unable to reach a reference(s). (No answer, no call back from voice message, no voicemail set-up, etc). We recommend that you notify references that we will be calling.
Name*

First NameLast Name
Phone Number*
Name*

First NameLast Name
Phone Number*
Name

First NameLast Name
Phone Number

VETERINARY INFORMATION
Veterinary Information release*

I agree to the release of any and all of my past and present veterinary records from the veterinary hospital(s)/clinic(s) listed below to Elmore SPCA. More than one can be listed, if you have used multiple veterinary services.This is my first animal, so I have not established a veterinary relationship.
Veterinary Office
Phone Number
Veterinary Office
Phone Number

ADOPTION TERMS AGREEMENT
I, understand that by entering my name, date, and checking the terms and conditions agreement below I am verifying that the above information is true and accurate, and that any misrepresentations made, may result in the rejection of this application. I understand that the completion of this application does not guarantee that I will be approved to adopt a pet from Elmore SPCA. I also that this authorizes Elmore SPCA to contact landlords, veterinarians, and references in order to verify all statements made in this application. I reserve the right of Elmore SPCA managers and Board of Directors to conduct follow-up telephone calls, as well as property checks in order to ensure the happiness, safety and well-being of any animal I am seeking to adopt by completing this application. I agree to relinquish ownership of my adopted animal despite licensing, if it is found at any time that I am acting against this legal contract.
Name:*
Submission Date

MonthDayYear
Date
By checking this box*

I agree to all of the terms and conditions of this agreement.
Upon submitting this form you will have completed the Elmore SPCA electronic adoption application. We will make every effort to process as quickly as possible. Application processing time is dependent upon our ability to verify information, reach contacts, and Elmore staffing levels. We thank you for supporting shelter adoption.
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Electronic Adoption Application