Animal Adoption Application

Animal Adoption Application
Your Name*
First & Last Name
Your Address*

Street Address

Street Address Line 2

CityState

Zip Code
Your Email*
Your Phone Number*

Area CodePhone Number
CellHomeWork
What animal are you interested in adopting? (Species or name)*
Names and ages of all permanent residents of your home (adults/children)*
Please list any pets currently living in your home, and if they are vaccinated and altered.
Vet reference (please call your vet and give notice that we will call. If you have not been to a vet before, please register with one soon.)*
Vet name, address & phone number
Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
RentOwn
Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
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 permenant resident.
YesNoNo children
Vet bills can be expensive. How do you plan on paying them? (IE: Pet health insurance)*
Additional reference (if desired)
Do you plan on keeping the pet crated while you are away?
How many hours a day will the animal be left alone?
Have you ever given a pet away, sold a pet, or surrendered a pet to a shelter or another individual? If so, why?
Under what circumstances would you consider it necessary to re-home a pet?
How often should an animal see the veterinarian?
Do you have any additional comments, questions or concerns?*
Adopter's Signature*
Signature

Clear
Signature date*
Thank you for taking the time to submit this form. Please feel free to contact us with any additional questions. Thank you!
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