Stay Scharp Rescue Pet Adoption Application Form

Stay Scharp Rescue Adoption Application

Perspective Pet Parent*

First NameLast Name

Name of Pet You Wish to Adopt*

Email Address*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

In what type of home do you live (apartment, duplex, condo, single family)?*

Do you own or rent your home?*

OwnRent

If you rent, please provide your landlord's information here:*

If you rent, what is your landlord's pet policy?*

Do you have a yard?*

YesNo

If "Yes" to the above, is it fenced? How high is the fence? Of what material is it made? Please describe:*

Do you own any pets and if so, what type of pets?*

Pet Name(s), Breed(s), Age(s), Sex(s):*

Are your pets up to date on vaccines?*

YesNo

Are your pets spayed/neutered?*

YesNo

If your pets are not up to date on vaccines or spayed/neutered (and on monthly heartworm prevention and flea/tick prevention, please explain why?*

Pet's disposition and behavior towards other dogs?*

Please provide your veterinarian's name, address, and phone number:*

Have you ever surrendered or given up a pet you own to any animal shelter including a "low" or "no kill" shelter? Have you ever given a pet away?*

YesNo

If you answered "Yes" to the above question, please provide detail:*

Are there children in the home? (If yes, please list ages)*

If you answered "Yes" to the above question, please provide detail:*

How many hours per day would the pet be alone?*

Where will the pet spend the day? Please Describe.*

Where will the pet spend the night? Please Describe.*

Will you crate your pet?*

If you have to leave town, emergently or planned, where would your pet stay?*

How would you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?*

Please provide the names, emails, and contact numbers for 3 personal references:*

Do you agree to provide regular healthcare by a Licensed Veterinarian?*

YesNo

Do you agree to keep the pet on monthly heartworm prevention?*

YesNo

Do you agree to keep the pet on monthly flea/tick prevention?*

YesNo

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo

If you answered "Yes" please provide a detailed description:*

By clicking the submit button, I agree to Stay Sharp Rescue's adoption process, will undergo a homecheck, and interview at the discretion of Stay Sharp Rescue.
By clicking the submit button, I understand Stay Sharp Rescue will check my references including veterinary and personal.
By clicking the submit button, I understand there is an adoption fee associated with adoption of a pet from Stay Sharp Rescue. I understand this fee will ensure the organization is equipped to rescue another homeless pet.
By clicking the submit button, I understand there is no "cooling off" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify Stay Sharp Rescue verbally and BY EMAIL and provide a 14 day period to allow Stay Sharp Rescue to make arrangents for my pet to be taken back into rescue.
By clicking the submit button, I agree to indemnify and hold harmless Stay Sharp Rescue against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
By clicking the submit button, I understand that Stay Sharp Rescue will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed.
By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet, I will be directed to surrender my pet to Stay Sharp Rescue and provide transport to where Stay Sharp Rescue deems appropriate.
By clicking the submit button, I understand that Stay Sharp Rescue requires that all pet's up for adoption must be spayed/neutered and this will be discussed with me.
By clicking the submit button, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent(s)*