Starfield Ranch Adoption Application

Adoption Application
This questionnaire is designed to help Starfield Ranch Animal Rescue and yourself determine if a specific rescue animal is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. Starfield Ranch reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions.
Applicant Information
Name of the animal in which you are interested:*
ID number of animal:
What interested you about this pet in particular?*
Your full name:*
Your age:*
Street Address:*
City, State, Zip*
Home Phone:

Area CodePhone Number
Cell Phone:*

Area CodePhone Number
When is the best time to reach you?*
E-mail:*
Employer:
Character reference and phone number:
Household Information
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
Who will be the pet's primary caregiver?*
Do you live in a*

HouseApartmentCondoMobile HomeOther
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord:
Does your landlord allow pets?*

YesNo
Are there any restrictions from your landlord or subdivision?*

Number of petsSize or weight restrictionsBreed restrictionsNone
Do you have a fully fenced yard?*

YesNo
Height and type of fence
How many adults are in your household?*
How many children are in your household?*
If children, what are their ages?*
Have your children been around animals before?

YesNo
Does anyone in your home have allergies to furry animals or have asthma?*

YesNo
Current/Previous Pet Information
List any pets you own or have owned in the past five years, and their ages*
How many of these pets are spayed/neutered?*
Where are these animals now?*
Have you adopted from an animal welfare group before?*

YesNo
If yes, what group?
Have you ever given up a pet?*

YesNo
If yes, what were the circumstances?*
Please provide the name and phone number of your current and/or previous veterinarian or clinic:
New Pet Information
What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)*
Why do you want to adopt a rescued pet?
Select the conditions you would accept in a pet:*

ScarringSpecial dietSkin problemsDaily medicationAllergiesArthritisBalance ProblemsBlindDeafSeniorMissing EyeMissing LimbSeparation Anxiety
Are you aware of crate training?

YesNoN/A
Have you ever house-broken a dog or puppy before?*

YesNoN/A
If the pet has an 'accident' in your home, what type of correction do you plan to use?*
How many hours each day will your new pet be home alone?*
Where will your new pet sleep at night?*
How will you supervise the pet's outdoor activity, if applicable?
Where will your new pet stay when nobody is home?*
What length of time will you allow your new pet to adjust to his new home?*
Are you willing to work through your new pet's issues, if any?*

YesNo
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?*

YesNo
Do you understand that a pet can be an 18-year commitment, and can cost $300 - $500 per year to care for?*

YesNo
Do you plan to take an obedience class with your dog?*

YesNoNot sureN/A
Are you aware that a large breed dog takes about two years to mature? Is this something you're prepared for?*

YesNoN/A
What circumstances would lead you to give up your new pet?*
If you had to give up your pet, what would you do with them?*
How did you find out about Starfield Ranch Animal Rescue?*

Adoptapet.comPetfinder.comFacebookFriend/Family MemberOther websitePetSmartInstagramOther
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.*

Yes
Should be Empty:

Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information