Animal Adoption Application

Animal Adoption Application
Full Name*

First NameLast Name
Phone Number
Please enter a valid phone number.
E-mail*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you 18 years of age or older?*

YesNo
What kind of animal are you looking to adopt?*

CatDogReptileRabbitOther
Birth Date*

MonthDayYear
Do you own your own home?*

YesNo
What is your landlord's policy on pets?:*
Type of Dwelling:*
Are you planning on moving within the next 6 months?*

YesNo
What are your plans for your pets if you move?*
What is your reason for wanting to adopt one of our animals?*

HousepetCompanionCompanion for petGiftOther
Where would the animal be kept when alone? **A video walkthrough will be required before the adoption is completed***
Do you agree with declawing?*

YesNoMaybe
Are your current cats declawed?*

YesNoN/A
Are any members of your household allergic to animals?*

YesNo
Please describe if yes:
Over the past 5 years, how many pets have you owned? (Include current pets)*
Please list breed, age, if they're still living with you? (if not, why?)
Have you ever lost or given away a pet?*

YesNo
If you currently own a dog or cat, how does he/she react to new animals?*
Are your present pets up-to-date on their annual vaccines?*

YesNoN/A
What vet do you use or plan on using? *
Are your present pets spayed or neutered?*

YesNoN/A
Please explain:
Were your previous pets spayed or neutered?*

YesNoN/A
Please explain
Can/Will you provide your animal with monthly flea/tick prevention if needed?*

YesNo
If your cat displays behavioral problems (such as poor litter box habits, inappropriate scratching etc.) how would you go about correcting the behavior?*

Contact a ProfessionalContact the RescuePersonal KnowledgeGet rid of the animalOther
What type of solution would you be willing to try if housebreaking accidents continue after the first week (check all that apply)?*

Move box to new locationTry a different litterClean box more oftenHave animal examined by vetReturn the animalNoneOther
What brand of food do you plan on feeding your new animal?*
Are you prepared to commit to a pet for 15 - 20 years (average life span)?*

YesNo
Where will your animal spend most of his/her time?*
Please tell us a bit about you and your household- if there is anything else you think we should know, please also note it here. *