Adoption Application Form
The Minnis Sanctuary
Applicant Details
Name
*
First Name
Last Name
Age
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you currently
Employed Full time
Employed Part time
Unemployed
Student
Retired
Phone Number (Mobile)
*
Phone Number (Home)
E-mail
*
example@example.com
Preferred method of communication:
*
Please Select
Text
Email
Phone call
Please list all people including ages of those living in the home
*
I / We live in a
*
Single Family Home
Duplex / Twin
Condo / Townhome
Mobile home
Apartment
Other
File Upload- Images of your home will your pet will have access (in lieu of home visit)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Do you
*
Rent
Own
Live with parents
If you rent please list your Landlords name and phone number
*
How long have you lived at your current address
*
Do you plan on moving in the foreseeable future? If so, where will you move and why?
*
Is anyone in the home allergic to dogs or cats?
*
Yes
No
If you have owned any animals in the past 10 years and they are not currently in your possession, what happened to them?
*
Do you have another pet?
*
Yes
No
Are all the pets in the home spayed and neutered?
*
Yes
No
Other
Please list all other pets in the home (Name, species, breed, age, gender)
*
Where do you keep your pet when you are not home?
*
File Upload - Images of where your pet will be when you are not home
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
When outside, how do you plan on keeping your pet safe?
*
File Upload - Images of the outside space where your pet will be kept
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
How do you handle undesirable behavior (chewing, accidents, scratching furniture, barking, counter surfing, ect)
*
Please add at least two personal references who do not live with you or are NOT related to you
*
Understanding that decompression needs to happen when welcoming a new dog into your home despite age; is having accidents in the home an issue
*
Yes
No
How do you plan on introducing your new pet to any existing pets?
*
Do you have a regular veterinarian?
*
Yes
No
Veterinarian’s name
*
Clinic Name
*
Clinic's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Clinic's Telephone
*
What is your estimated cost for annual routine veterinary care for the pet you wish to adopt?
*
Can we contact your current veterinarian to obtain health care information on your current pets?
*
Yes - If you select yes, please contact your veterinarian and give them permission to speak with us
No
Name of the Pet you are interested in
I want to adopt a (select all that apply):
*
Dog
Cat
Female
Male
I would prefer the size to be (select all that apply)
Small: 5lbs - 20lbs
Medium: 25lbs - 45lbs
Large: 50lbs - 80lbs
X-Large: 85lbs or more!!
Please list any breed requirements
Why do you want to adopt this pet (check all that apply)
*
Companionship
My children will learn to be responsible for and to care for another creature
Love animals. Want to help a pet in need
Want to breed
Looking for mouse/rodent control for home
Feel sorry for the animal. The animal is so cute I can’t leave it behind
Gift for someone.
Companion for another pet
Other
Is there anything additional you would like us to know?
Who will be primarily responsible for the care of this pet? Name and Age
*
I UNDERSTAND & AGREE1.) The above statements are true to the best of my knowledge.2.) I understand that my pet needs to be provided with food, water, and shelter at all times.3.) I understand that The Minnis Sanctuary cannot guarantee the temperament or behavior of any animal I adopt.4.) For dog adoptions, I understand that my dog must be contained to my yard at all times, except when accompanied by me on a leash.5.) I understand that while animals are cared for and up-to-date on their vaccinations there is still a chance they may carry a disease or infection.6.) I understand that it is Maine State Law to keep my dog vaccinated against rabies and to purchase a dog license every year.
*
I confirm that all information supplied above is correct and accurate.
Signature
*
Submit
Submit
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