Pet Adoption Application

Pet Adoption Application
Name:
Email:
example@example.com
Full Address, City, State, Zip:
Cell Phone:
Rescue Interested In:
Tell us a little about yourself, your family, and lifestyle:
To Be Considered for an Adoption, you must:

Be 18+ or Have Consent of an Adult Living in your Household Have a valid Photo ID with Present Address
Why Would You Like to Adopt a Pet? (Check all that apply)

Companion for Self Companion for Other Pet For Children Gift for Other Watch Dog/Protection
Living Situation

Own Rent
Number of Adults 18+
Number of Children under 18
Ages of Children
List Any Pet Allergies for Household Members
Do you have a fenced yard?

No Yes
If yes, what type of fence? (Wood, Chain link, vinyl, iron, etc)
How long at current address?
If less than one year, how long at previous address?
Do you have plans to move in the near future? If yes, will you take your Pet?

Yes No
If renting, are pets allowed?

Yes No Unsure
If renting, what type of rental? (Apartment, Dorm, etc.)
If renting, Landlord Name:
If renting, Landlord Phone:
Pet Care Information
Who will have primary responsibility for the care of your new pet?

Adult Children Pet Sitter Other
How many hours per day will your pet spend alone without humans home?
How many days per week will your pet spend alone without humans home?
Do you have contingency plan for pet in case you are unable to care for it in the future?

Yes No
If yes, what is your contingency plan?
Dog Adoptions Only
Where will you keep your dog during the day?

Inside (Loose) Inside (Crated or Confined) Garage/Porch Inside and Outside
If inside and outside, how many hours a day outside?
If inside and outside, what type of shelter outside?
How much time a day do you plan on exercising your dog?
Describe how will you provide training
How will you discipline your dog if it does something wrong?
Cat Adoptions Only
Where will your cat be kept?

Inside House Only Inside Garage/Porch Outdoor Only Indoor and Outdoor
If Indoor and Outdoor, how many hours a day outside?
Do you plan on declawing your cat?

Yes No
Pet Ownership History
Do you currently have other pets?

Yes No
Have you ever surrendered or returned past pets?

Yes No
If yes, please explain.
List Current or Previously Owned Pets
Pet #1
Type:
Breed:
Spayed/Neutered?
Why don't you have this pet anymore and date?
Pet #2

Type:
Breed:
Spayed/Neutered?
Why don't you have this pet anymore and date?
Pet #3

Type:
Breed:
Spayed/Neutered?
Why don't you have this pet anymore and date?
Veterinary Info
Vet Name
Vet Location:
Vet Phone:
Initial each item and sign the date the bottom.
I understand that all adoptions are at the discretion of Rosemarie's Rescue Ranch. Completion of this application does not guarantee acquisition of a pet.
Initial
I understand that any false information provided may void the application.
Initial
I am willing to make a 10-15 year commitment (20 for cats) for my new pet.
Initial
I will take my pet for annual vet visits for a wellness exam/test, vaccinations, and as needed for injury, illness, etc.
Initial
I will keep my pet on regular flea/tick control, as well as monthly heart worm control for dogs.
Initial
If for any reason the adoption does not work out and/or I cannot keep my pet in the future, I agree to notify Rosemarie's Ranch prior to transferring ownership to another person, or returning to Rosemarie's Rescue Ranch without surrendering to control/shelter/another rescue.
Initial
I understand Rosemarie's Rescue Ranch has the right to reclaim ownership should the intended owner not meet (or no longer meet) the requirements set forth under this agreement.
Initial
I allow Rosemarie's Rescue Ranch access to all veterinary and/or town records for any current or prior pets.
Initial
I fully understand and agree to assume all risk involved in any and all duties that I perform as an adoptive pet parent through Rosemarie's Rescue Ranch, Inc. of West Caldwell, NJ. I also agree to hold Rosemarie's Rescue Ranch, Inc. harmless for any injuries or damages that I might sustain during the course of said pet ownership, wherever they may occur.
Initial
*NJ Law states it is illegal to keep pets outside for longer than 30 minutes in extreme weather conditions*

(over 90 degrees or under 32 degrees)
Signature *

Clear
Date: *

Month Day Year
Should be Empty:

Pet Adoption Application

Pet Care Information

Dog Adoptions Only

Cat Adoptions Only

Pet Ownership History

List Current or Previously Owned Pets

Veterinary Info

*NJ Law states it is illegal to keep pets outside for longer than 30 minutes in extreme weather conditions*

NJ Law states it is illegal to keep pets outside for longer than 30 minutes in extreme weather conditions