Adoption Application
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number (Mobile)
*
-
Area Code
Phone Number
E-mail
*
example@example.com
Preferred method of contract:
Call
Text
Email
Which pet are you interested in adopting?
Are you open to adopting pairs?
Yes
No
Undecided
Your cat will be:
Indoor only
Indoor with supervised outdoor time (leash/catio)
Indoor/ Outdoor unsupervised
Would you like to foster?
Yes, just foster
Yes, foster to adopt
No, just adopt
Do you own or rent?
*
Own
Rent
Are there any children in the home?
*
Yes
No
If yes, please list ages below.
How many hours of the day will the pet be alone at home?
*
If you have to leave town, emergent or planned, where will your pet stay?
*
Do you own any other pets? If yes, how many? (Cat or dog)
*
What is the breed of your pet?
Is your pet spayed / neutered?
Yes
No
Is your pet used to other pets?
Yes
No
Please provide three references including name and phone number.
*
Do you have a regular veterinarian?
*
Yes
No
Veterinarian’s name
*
Clinic's Telephone
*
-
Area Code
Phone Number
Have you ever been convicted of an animal related crime, such as animal cruelty, animal theft, and or animal abandonment? (If yes please explain in detail)
*
Agreement
*
By clicking the submit button, I agree to Peachy Pals Rescue adoption process, will undergo a homecheck, and interview at the discretion of Peachy Pals Rescue. By clicking the submit button, I understand Peachy Pals Rescue will check my references including veterinary and personal. By clicking the submit button, I understand there is an adoption fee associated with adoption of a pet from Peachy Pals Rescue. I understand this feeling will ensure the organization is equipped to rescue another homeless pet and therefore, adoption fees and deposits are non refundable. By clicking the submit button, I agree to indemnify and hold harmless Peachy Pals Rescue against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed. By clicking the submit button, I understand that Peachy Pals Rescue will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed. By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet at any time, I will be directed to surrender my pet back to Peachy Pals Rescue and provide transport to where Peachy Pals Rescue deems appropriate. By clicking the submit button, I verify all of the above information is true and accurate.
Signature
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