Out of the Rein Adoption Application
Name (or type) of the pet you are applying for:
Today's Date
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Month
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Day
Year
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Full Name
*
First Name
Last Name
Date of Birth
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Month
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Day
Year
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Phone Number (mobile if possible)
*
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Area Code
Phone Number
E-mail
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Number of adults (18+) living in the household:
Number of children (under 18) living in the household:
Age of any children under 18 in the household:
Do you own or rent?
Please Select
Own
Rent
Renters: Does your landlord permit you to have pets?
Please Select
Yes
No
Renters: Does your landlord have any breed or weight restrictions? If so, what?
Renters: have you paid your pet deposit?
Yes
No
Other
Landlord's name and phone number:
Please describe your current pets (name, age, type, gender, how long you've had the pet):
Are all of your dogs/cats spayed or neutered?
Yes
No
Not applicable
If they are not all spayed/neutered, please explain why.
Do your current cats/dogs have a current rabies vaccination?
Yes
No
Not applicable
If your dogs/cats do not have a current rabies vaccine, please explain why.
Are your dogs kept on heartworm preventatives?
Yes
No
Not applicable
My current dogs are kept ________ during the day.
Inside
Outside
Not applicable
Other
My current dogs are kept ________ at night.
Inside
Outside
Not applicable
Other
When my current dogs are outside, they are:
In a fenced yard
In a pen/kennel
Tether/runner/chain
No fence. (Dog will be expected to stay in the area on their own.)
Electronic Fence
Other
My current cats are kept ________ during the day.
Inside
Outside
Not applicable
Other
My current cats are kept ________ at night.
Inside
Outside
Not applicable
Other
Please explain where your new pet will be kept during the day?
Please explain where your new pet will be kept during the night.
Have you had any other pets in the past 5 years, if so what happened to them?
Name of primary veterinarian:
*
Primary veterinarian's phone number.
May we call your veterinarian as a reference?
Yes
No
This new pet will be
a pet for me.
a gift for someone in my household.
a gift for someone outside of my household.
Other
If you do not have a previous pet with veterinary history, please provide the name and phone number for a professional reference. They may not be a relative.
I understand that any pet I adopt from Out of the Rein must be spayed/neutered and fully vaccinated within 30 days, should they not arrive to you fully UTD. I will provide proof of vaccination, Rabies certificate (once they are old enough to receive), and proof of spay/neuter to OOTR or understand that the pet may be repossessed or legal action may be taken.
Yes
No
Please leave additional comments/concerns here
If you are under 21 years of age, please provide a parent or legal guardian's phone number.
We generally reply to adoption applications by email. Is this ok?
Yes
No, I prefer to be contacted by phone.
Are we able to text you on the primary number you provided to obtain additional information or clarification regarding your application?
Yes
No
By signing my electronic signature here, I agree that all of the information I proved is true to the best of my knowledge.
*
Where did you hear about our rescue?
*
Please Select
Facebook
Pet Finder
A friend or family member
Other
If you selected other please explain below:
Submit
***Please note that failure to comply with the spay/neuter requirement can result in an arrest warrant and/or repossession of the animal.***
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