Ninja Paws Rescue Adoption Application

Ninja Paws Rescue Adoption Application

Thank you for considering adopting a rescue animal. Please fill out the form below to begin the adoption process.
Name of dog/cat you are interested in:
Primary Adopter’s full name

First NameLast Name
Email Address
example@example.com
Cell Phone:
Please enter a valid phone number.
Home Phone:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Employer:
Drivers license number:
Have you or any household members ever been accused or convicted of animal, cruelty, and/or neglect. If yes, please explain.
Are all members of household in agreement with this adoption?
Who will be pet’s primary caregiver?
Non-relative, personal reference with phone number:
Do you live in:

HouseApartmentMobile HomeTownhome
Do you:

OwnRent
If you rent, please provide the name/phone number of the landlord/rental company:
Are there any breed/size restrictions from your landlord or subdivision?

YesNo
Can proof of a pet deposit be obtained from your landlord?
Do you have a fully fenced yard?

YesNo
Please state height and type of fence:
How many adults in your household?
How many children in household and ages?
Does anyone in your household have dog/cat allergies?
List any pets you have owned in last 5 years and no longer own:
Where are these animals now?
Are all current pets spayed/neutered?
Will you be able to provide proof that all current pets are up-to-date on vaccinations?
Have any pets in your home, past or present, been diagnosed with an infectious disease (FIV, Heartworms, Distemper, Parvo, etc?) if yes, please explain.
Do you agree to provide heartworm prevention for all adopted dogs?
Have you adopted from an animal welfare group before?
If yes, what group?
Have you ever given up a pet?
If yes, what were the circumstances?
Do you have any experience with crate training?
Have you ever housebroken a dog or puppy before?
How many hours each day will your new pet be home alone?
Where will your new pet sleep at night?
How will your new pet get daily exercise?
Will your new pet be:

Totally indoorsMostly indoorsMostly outdoorsTotally outdoors
Where will your new pet stay when nobody is home?
Do you travel frequently? If yes, who will care for your pets?
Are you aware that a new environment is stressful for your pet and they may exhibit uncharacteristic behavior in the beginning?
What circumstances would lead you to give up your new pet?
If you had to give up your pet, what would you do with him/her?
How did you find out about Ninja Paw Rescue?
Rescue Animal Information
Type of Animal

DogCatOther
Age Preference

Puppy/KittenAdultSenior
Experience with Pets

ExperiencedFirst-Time Owner
List current pets (ages,breed,weight)
Veterinarian Information

Please provide the name and contact information of your current or previous veterinarian.
Veterinarian's Name

First NameLast Name
Veterinarian's Phone Number
Please enter a valid phone number.
Home Visit

Are you willing to have a representative visit your home if requested before the adoption is finalized?
Willingness for Home Visit

YesNo
Additional Comments
I have read the above information carefully and have provided answers honestly. I understand that omission of information and/or failure or refusal to answer all questions and sign therein may result in this application being declined. If an omission or untruth is discovered after an animal is placed in my care, Ninja Paws Rescue reserves the right to anullify the adoption and reclaim the animal. I give Ninja Paws permission to fully investigate the information provided and contact any and all references listed here in. If the application passes review, I agree to possible home visit on a mutually agreed-upon date between myself and a Ninja PawsRescue representative before a final decision is made.
My typed name will serve as my signature:
Date application submitted:
Should be Empty:

Ninja Paws Rescue Adoption Application

Rescue Animal Information

Veterinarian Information

Home Visit