Email address
*
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Secondary Applicant Name
First Name
Last Name
Secondary Applicant Phone
-
Area Code
Phone Number
Are you employed? Name of employer, phone # and years worked there.
*
Are you interested in a specific pet that you have met at the shelter or seen on our website? Please let us know who your top choices are.
What kind of animal are you interested in? (Species and sizes) list all interested in
Do you have a regular veterinarian?
*
Yes
No
Other
If so, which veterinarian?
*
May we contact your vet for a reference?
*
Yes
No
Other
Are all pets you currently have up to date on annual vaccines?
Yes
No
Other
Please list 2-3 references with phone number that we may contact
*
Why are you interested in adopting a pet? (check all that apply)
*
Companion
Child's pet
Gift
Guard dog
Company for Other Pet
Other
What qualities are you looking for in a pet? (check all that apply)
*
Friendly
Playful
Affectionate
Energetic
Aggressive
Quiet
Gentle
Other
What energy level are you looking for?
*
High Energy (Daily vigorous exercise)
Medium Energy (A daily walk)
Low Energy (Couch buddy)
Other
How do you feel about the following behaviors?
*
Rows
OK or Manageable
Cannot tolerate
Jumps on people
Chews
Mouthy
Doesn't like other animals
Doesn't like kids
Destructive inside
Separation anxiety
If a behavior cannot be tolerated or changed after adoption, what steps would you take?
*
Return to shelter
Give away
Consult a professional trainer
Other
Do you currently have pets in the home?
*
No
Yes
If you do have pets in the home, please describe them below.
How many people are in your household?
*
What are the ages of the people in your household?
*
Where do you live?
*
House
Apartment
Condo/townhouse
Other
Do you own or rent?
*
Own my own home
Rent
Live with parents or homeowner
Other
If you rent, provide the name and phone number of your landlord. If you live with your parents or the homeowner, please provide their name and phone number. *Required if you do not own your home*
If you rent, is a pet deposit required?
Yes
No
Don't know
Other
How many hours will your pet be left alone each day?
*
1-2 hours
3-4 hours
4-6 hours
8-10 hours
10+ hours
Other
Where will your animal live?
*
Inside
Outside
Other
What are your plans for your pet when you are NOT at home? Please describe in detail.
*
What are your plans for your pet when you are AT HOME and AT NIGHT? Please describe in detail.
*
Do you have a fully fenced yard?
*
Yes
No
Other
Have you ever surrendered a pet? If yes, please explain
*
Have you ever needed to euthanize an animals? If so, please explain
*
Who will be responsible for the care of the animal?
*
Please tell us anything else you would like to share about you, your family, your lifestyle, your ideal pet, your past pets, or anything else.
Verification
*
I verify that I am 18 years of age or older, have identification showing my current address, and have knowledge and consent of my landlord. I understand falsification of information will lead to rejection of this application. I understand filling out an application does not reserve or hold an animal for me prior to adoption and that CNP reserves the right to refuse adoption to anyone.
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