Adoption

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

What pet are you interested in adopting?

What made you choose this pet ?

Who are you adopting this pet for ?

If other please explain

Do you understand that it can take up tp 3 months before a pet begins to feel comfortable and gets set into their routine?

Household Information

Do you live in a

If renting does your landlord allow pets?

If renting is there a breed/ weight restriction

If renting a letter from the landlord is required stating that they approve the pet being brought into the home. We will need their Name and current contact info before the application can be approved. If in an apartment we will need a letter of pet approval and a copy of the reciept if a pet deposit is to be made along with the Managers name, Complex name and contact info.

Is everyone in the house in agreement to adopt?

Please describe your household environment:

How many people live in home?

Adults

Children (18 and under)

Where will this pet be kept?

Do you have a secure fenced yard?

Where will pet stay when you are gone during the day?

Where will pet sleep at night?

Where will pet stay in case of emergency, family vacation or business trip?

Do you own other dogs? If so how many?

Do you own other cats? If so how many?

Do you own livestock ? (cows, chickens, goats, horses)

Have your other pets displayed aggressive behavior? If yes please explain

Are all pets in household up to date on vaccinations

Are your pets on flea/tick prevention?

Are your pets on heartworm prevention

Please provide Vet Reference

Please provide addition personal reference

Have you ever adopted a pet before?

Have you ever taken a pet to the shelter? If yes, please explain

Have you ever had a pet euthanized for any reason other than terminal illness? If yes please explain

Are there any behaviors you are NOT willing to work through?

Will you be willing to call us for advice/work with a trainer on any of these issues if a problem persist

Do you agree to abide by our guidelines and return the pet to us if you can not keep it; and to notify us if pet is lost or stolen or dies?

I acknowledge that the submission of an adoption application does not guarantee I will be approved to adopt this pet. I agree that I nor anyone in my home have ever been subject to legal action for cruelty or neglect of animal(s). I agree that I nor anyone in my home have ever owned any animal which has been confiscated by animal control or human organization for violations or state or local animal control regulations.

Signature

Form

Adoption Application