Small Animal Application

Applicants must be 18 years of age or older to adopt from Fresh Start Animal Rescue League.

Before starting this application; are all pets currently in the home spayed/neutered and current on their vaccines? If the answer is no, please do this before applying for one of our pets. We require all animals currently in the home be spayed/neutered and current on their vaccines prior to adopting from us. Please complete all the information on the following pages. Missing information may delay the adoption screening process. Completion of this application form does not guarantee that FSARL will place one of our pets in your care. Completion of this questionnaire authorizes FSARL Members to verify any information contained herein, including verification of medical records of any present or prior pets treated by the veterinarians listed. Completion of this adoption process is an indication that you have read, understand and agree to abide by our Animal Adoption Agreement and that the information contained within this application is accurate and not misleading in any way. All adoptions are at the sole discretion of FSARL and we have the right to refuse an adoption if we see fit.

Name*

First NameLast Name

Animal name

potential pet

Phone Number*

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

What do you plan to use to house the pet you're planning to adopt from FSARL? Please be as detailed as possible. (include enrichment items, size of enclosure, heating, bedding, etc.)*

Do you have any experience owning this type of pet, if any please elaborate:*

What are you planning to feed this pet? Please be as detailed as possible.*

No, they don't need vettingYes, my vet has experience with this animalNo, I don't know of a vet that will take this animalYes, this animal needs vetting

Please explain your answer to the question above:*

YesNoNot Applicable

5-10 years10-15 years15-20 years20+ years

YesNo

Give to a friend or family memberSell on facebook/craigslist/otherReturn to FSARLTake to the vet for humane euthanasia

YesNoThe whole family will care for this pet but I will be responsible for its careI am getting this pet as a gift for my [family member] and they will be providing careOther

If you selected "other" above please elaborate:

Please provide your vet's name, address and phone number and let them know we will be contacting them:

Please provide us with at least 2 personal references NOT related to you. Also, please use references that do not live at the same residence. Your personal references should be able to have an idea of what kind of pet owner you are. You can use: coworkers, neighbors, friends, people who would know about your animals.

Again, your references cannot be related to you and should reside in separate homes from you and eachother.

Thanks!

Reference 1:

NamePhone Number

Reference 2:

NamePhone Number

By signing this document I understand that I may or may not be selected to provide the pet I am interested in their furever home. I also agree that Fresh Start Animal Rescue League will be contacting my references and vet to verify the information in this form. Adoption fees are considered a donation and I understand they are NON REFUNDABLE. If for any reason I am unable to keep this pet, I will return it to FSARL and my adoption fee will not be returned to me. I filled out this application to the best of my ability and I agree that everything I put in this document is accurate and I was not purposely decietful in anyway.

Name*

First NameLast Name

Date*

Date

Signature*