Form
Thank you for your interest in adopting a pet. We require you to fill out an application prior to meeting any animals, this is for optimal safety for the pets and for you. We want to make sure not only that the animals will be safe in their new homes, but that they are also a good fit for you! Adoptions are done on a first-come first-serve basis, and this application does not serve as a "reservation" for a specific animal.
Today’s Date
-
Month
-
Day
Year
Date
Adopter Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pet that you’re interested in:
If pet is a dog do you have experience working with this specific breed?
Yes
No
Not applicable
Which best describes your age?
Under 18
18-35
36-59
60+
If you answered Under 18, please provide your parent or guardians name
First Name
Last Name
Parent or Guardians Phone Number
Please enter a valid phone number.
Type of Housing
Apartment
Condo
House
Trailer
Other
Do you own or rent your home?
Own
Rent
If rent, please provide landlord’s name and number.
Number of adults living in home
Number of children living in home
Ages of children living in home
0-12 months
1-5 years old
6-9 years old
10-13 years old
Teenagers
Are you adopting for yourself or for someone else?
Me
Someone Else
My pet will live:
Indoors
Outdoors
Both
Do you plan on or have you ever gotten a pet declawed?
Yes
No
Will you be able to get pet spayed/neutered within 30 days of adopting?
Yes
No
Please give information on the pets in the home currently
I have 1 or more cats
I have 1 or more dogs
I have one or more small animals
None currently but have had pets before
I have no pets and never have
Please enter the following information about your pets in the home currently: (Type, age, breed, gender, spayed/neutered?, up to date on vaccinations?)
Name of current or past veterinarians/vet clinics
Please check additional topics you would like to discuss
Introducing Other Pets
Litterbox/Outdoor Potty Training
Pets & Children
Post Adoption Support
Other
Please select the earliest date you would be available to meet the cat
-
Month
-
Day
Year
Date
I certify that all of the above information is true and accurate. I understand that if I adopt a pet from Kaley’s Kozy Korner this document becomes part of the adoption record. By signing this form, I hereby acknowledge that I am at least 18 years old.
Signature (if not 18 years or older please have parent or guardian sign)
Submit
Submit
Continue
Continue
Should be Empty: