Adopt-A-Pet Application

ABOUT YOUR HOME:
Type of dwelling:
How long have you lived at your current address?
Own Or Rent
If renting, Landlord's name
Landlord's Phone Number
Are you planning on moving in the next year?
Do you have any objection to a mandatory home visit prior to being approved for adoption?
Do you have a fenced yard? Yes/No
Front, Back or Both?
Type of fence
Height
In public view? Yes/No
Do you have a doggy door? Yes/No
Do you have a pool?
Fenced or open?
Do you live in a rural or city neighborhood
Is there a lot of traffic?
Is it high or low crime area?
Are their any problems with neighbors?

Adoption Questions
Do you have a preference regarding your adopted pet?
Can you handle a special needs adopted pet?
Where will the adopted pet be staying?
Does your family work, or is someone home all day?
This adopted pet will be alone for (approx): hours per day?
Do you agree to keep a current ID tag on the Pet at all times?
Which member of your household will be primarily responsible for feeding, training and generalcare of your new adopted pet?
Have you ever had to give up a Pet? Please explain.
What would you do if your pet exhibited undesirable behavior (i.e. being destructive, soiling the house, excessive barking, etc.)?
Have you ever been in a dog obedience class?
Have you ever belonged to a kennel club or other dog related organization? Yes No
What is your definition of disciplining your dog?
What arrangements will you make for your pets when you are away from home and cannot take them with you? Boarding Home Pet Care Friends Family Other
Do you have the financial means to take care of the veterinary and health needs of an adoptive pet, including, vaccinations, dental care, heartworm preventatives and geriatric care?
In your own words, why do you want to adopt a pet?

References
Which Veterinarian do you currently use?
Vet Phone Number
Vet records are under what name?
Reference#1 Name
Phone Number
Relationship to you?
Number of years known?
Reference#2 Name
Phone Number
Relationship to you?
Number of years known?
By signing below, / hereby agree to assume all responsibility for the care and protection of the my adopted pet to the best of my ability.
Signature

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ABOUT YOUR FAMILY AND PETS: