Adoption Application
Animal of interest
*
Species, or a specific animal. Ie Bearded dragon/fred
Applicant Details
Name
*
First Name
Last Name
Age
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number (Mobile)
*
Format: (000) 000-0000.
E-mail
*
example@example.com
I / We live in a
*
Single Family Home
Duplex / Twin
Condo / Townhome
Trailer
Apartment
Other
Do you have another pet?
*
Yes
No
What other pets do you have ?
*
Do you have experience with the species you want to adopt?
*
Yes I have/had this species!
Yes I work with this species!
No, but I have done a LOT of research!
No but I am willing to learn!
Please describe proper care for the species you'd like to adopt, and your experience with the species.
*
Do you have an enclosure/supplies for the animal you want to adopt?
*
Yes I have everything!
I have some things
I need help making sure I get the right products
No
Other
What size enclosure do you intend to keep the animal in?
*
Do you intend to cohabilitate this animal? If so please describe the other inhabitants ( species,sex, age, size etc.)
*
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
*
Format: (000) 000-0000.
If you live with other people, do they know and agree to this adoption?
*
Yes they are on board!
No, I havnt discussed it.
If you rent is the landlord aware and okay with you adopting this animal?
*
Yes they are on board!
No, I havnt discussed it.
Do you have someone to care for this animal if you are out of town, or in case of emergency etc?
*
Yes I am prepared!
No, I will have to work that out.
Other
Have you checked your local laws and insured this animal is legal to keep in your county,city,state etc?
*
Yes, it is legal !
Yes, i have a permit!
No I didnt think about it
Other
*
I hereby certify all information provided in this form is truthful to the best of my knowledge
*
I understand that filling this form out does not mean I will be approved. There is still an approval process
*
I understand that even if I am approved there is still an adoption fee I will be required to pay
*
I understand that at anytime, for any reason I can return the animal to the rescue as a surrender however I will not receive a refund.
*
I understand and agree that if I go through with the adoption the animal is at that point my full responsibility to take care of properly and maintain legal ownership status and follow all laws regarding the animal
*
I understand that any animal adopted is a rescue animal that came from less than ideal conditions and while the animal has been cleared and deemed healthy health conditions can still arise, and unknown health conditions may be present. All adopted animals are "as is" these are not 100% perfect animals straight from a breeder with a health garauntee and perfect garaunteed genetics. These animals may have missing limbs, prior health issues, special needs etc that will be disclosed and properly treated prior to adoption.
Signature
Submit
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