Animal Adoption Application ARP

Animal Adoption Application
What animal are you interester in adopting? (Species, name)*
Your name*
First & Last Name
Your Address*

Street Address

Street Address Line 2

CityState

Zip Code
Your Email*
Your Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
Names and ages of all permanent residents of your home (adults/children)*
Please list any pets currently living in your home, and if they are vaccinated and altered.
Vet reference (please call your vet and give notice that we will call. If you have not been to a vet before, please register with one soon.)*
Vet name, address & phone number
Are you planning to move in the near future?*

YesNo
If moving soon, to what city/state?
When will you be ready to adopt this animal?*

TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Is anyone in your home allergic to the animal you're planning to adopt?*

YesNoYes, but it is tolerable for them and they are OK with it.
Are you familiar with the breed?*

YesNo
If you answered no to the question above, please visit Google and do a bit of research so you can be prepared for your new family member!
You live in a:*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you rent or own this property?*

RentOwn
If you rent, you must give the person you must provide a written letter from your landlord or a copy of the section of your lease stating that you are allowed to have this type of animal and showing any limitations.

If you live in a condo or townhome, you must show us written proof that you are allowed to have this type of animal there and show any restrictions.

If you own, you must show proof of home ownership.
Do you have a yard?*

Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.
If applicable, will your children be taught how to play gently and kindly with this animal?*

YesNoNo children
We are a small municiple shelter. Our adoptable pets are spayed/neutered and vaccinated for rabies before adoption. Do you understand that further vetting will be your responsibility?*

Yes
Please provide 2 personal references
Do you have any additional comments, questions or concerns?*
By checking the box below, you understand the terms of this form. You hereby agree that you will not use this animal in any sort of fighting, breeding, or cruelty. You will love and care for this animal for the rest of its life, and you are ready to commit to that. You also agree, that if for any circumstances you can no longer provide love and care for this animal, you will contact Milltown Animal Control. You understand that while Milltown Animal Control will make every effort to ensure that this animal is healthy and has a good temperament, we make no guarantees. Milltown Animal Control will not be liable for expenses incurred on behalf of this animal after the date of adoption.

I understand the above, and have tried to the best of my knowledge to make sure all information is correct.
Adopter's Signature*
Signature date*
Thank you for taking the time to submit this form. Please feel free to contact me (the person you are adopting from) or any of the admins in the Adopt/Rehome network. After you click the Submit, you will be redirected to the main page, and you will also recieve a confirmation email. Thank you!
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