Animal Adoption Application BCO

Animal Adoption Application
What animal are you adopting? (Species, name)*
Your name*
First & Last Name
Your Address*

Street Address

Street Address Line 2

CityState

Zip Code
Your Email*
Your Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
Names and ages of all permanent residents of your home (adults/children)*
Who will be the primary caretaker for the pet?*
Have you owned a pet in the past 7 years?*

YesNo
Please list any pets currently living in your home, and if they are vaccinated and altered.
Please list any previously owned pets' names and species, and vet office used for them, if different than current office, in the last 7yrs
Vet reference (please call your vet and give notice that we will call. If you have not been to a vet before, please input which you'll use.)*
Vet name, address & phone number
Have you rehomed or given away a pet? If yes, please explain the circumstances.*
Are you planning to move in the near future?*

YesNo
How will the pet be cared for when you go on vacation, travel, or in an emergency situation that would cause you to be unable to provide care?
When will you be ready to adopt this animal?*

TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Is anyone in your home allergic to the animal you're planning to adopt?*

YesNoYes, but it is tolerable for them and they are OK with it.
You live in a:*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you rent or own this property?*

RentOwn
Please provide landlord name and phone number and/or email, if applicable *
Will your cat be*

Indoor onlyIndoor/outdoorOutdoor only
Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.
Please be aware that dogs/cats given as gifts for the holiday season are usually returned to shelters or given to pounds after the New Year's. With this in mind, please make sure that any animal you are adopting will be a permanent resident.
If applicable, will your children be taught how to play gently and kindly with this animal?*

YesNoNo children
Vet bills can be expensive. How do you plan on paying them? (IE: Pet health insurance)*
What will you do if your adoptee and current pet(s) don't get along?

Seek assistance from BCOSeek assistance from trainerLet them sort it out themselvesRehome one of the petsOther
Additional references
Do you have any additional comments, questions or concerns?*
How much are you willing to pay for an adoption fee?*
If you are paying an adoption fee, what is your method of payment?*

CashPaypalOther/None
By checking the box below, you understand the terms of this form and adoptee. You hereby agree that you will not use this animal in any sort of fighting, breeding, or cruelty. You will love and care for this animal for the rest of its life, and you are ready to commit to that. You must keep the pet up to date with vaccinations and bring it to the vet for any and all medical care. You also agree, that if for any circumstances you can no longer provide love and care for this animal, you will contact Barn Cat Outreach via 585-534-5711 or barncatoutreach@gmail.com and explain your situation before taking the animal to a shelter.

I understand the above, and have tried to the best of my knowledge to make sure all information is correct.
Adopter's Signature*
Signature date*
Thank you for taking the time to submit this form. Please feel free to contact me (the person you are adopting from) or any of the admins in the Adopt/Rehome network. After you click the Submit, you will be redirected to the main page, and you will also recieve a confirmation email. Thank you!
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