Vegas Roots Rescue Adoption Application
Full Name:
Address:
Address
Street Address Line 2
City/State/Zip
State / Province
Postal / Zip Code
Cell Phone #:
Secondary #:
Email Address:
example@example.com
Driver's License #:
I am interested in adopting (dog's name):
Existing Pets
Animal Type
Age
M/F
Vaccines Current
Spayed/Neutered
Breed
Size
Vet
Additional Comments
Pet 1
Dog
Cat
Other
Pet 2
Dog
Cat
Other
Pet 3
Dog
Cat
Other
Pet 4
Dog
Cat
Other
Number of Residents:
Ages:
Do you Rent or Own?
Type of Property?
If applicable, does your HOA/Landlord allow animals? Are there restrictions? If so, with size or breed?
Do you have a fenced yard, if so, how tall is it?
Where will the animal be kept during the day/night?
How many hours a day will the animal be alone?
What would cause you to return an animal?
Signature
Date
/
Month
/
Day
Year
Date
Preview PDF
Submit
Should be Empty: