Adoption Application
Incomplete applications can not be processed. Contact your Veterinarian to give permission to speak to us.
Applicant Information
Applicant Name
*
First Name
Last Name
Applicant Age
*
Email
*
example@example.com
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Pet and Household Details
Type of pet you are looking to adopt or pet name used in advertisement:
*
Housing Situation:
*
Live with parents
Rent
Own
If you rent, does your landlord permit pets?
I’m not sure
Yes
No
Landlord name and phone number:
Type of Housing:
*
Apartment
Condo/Townhome
Private Home
Are all members of your household in agreement about adopting a pet?
*
Yes
No
I haven’t told them yet
Number of people in household:
*
Household members age and relationship to you:
Household allergies to dogs or cats:
Dogs
Cats
I’m not sure
None
Why do you want to adopt a pet?
*
Preferred age of pet
*
Baby
Young
Adult
Senior
Preferred energy level of pet
*
Mellow
Active
Energetic
Is this pet going to be a gift for someone else?
*
Yes
No
If yes, who is the pet for?
On a regular day, how many hours will the pet be left alone?
*
Pet Care Preferences
What would you likely do if your new pet develops undesirable behavioral issues?
*
Are you planning on declawing your cat?
*
I am not adopting a cat
Yes
No
Maybe
Do you plan on letting your cat outdoors?
*
I am not adopting a cat
Yes
No
Maybe
Do you currently own any pets?
*
Dog(s)
Cat(s)
Other
None
Current pets' names and ages (for dogs and cats)
If you currently have pets, are they spayed or neutered?
*
I do not have any pets
Yes
No
I’m not sure
Not yet, but will be
Do your pets go to the Veterinarian for routine exams and care?
*
I do not have any pets
Yes
No
I’m not sure
Names and types of pets previously owned
*
Have you ever given away, rehomed, or surrendered a pet?
*
Yes
No
If so, why and where did the pet go?
Veterinary Information
Current or most recent Veterinarian 1 - Name, phone, and name on account (if different than applicant name)
*
Most recent or current Veterinarian 2 - Name, phone, and name on account (if different than applicant name)
Personal Reference #1
Name
*
First Name
Last Name
Relation to you:
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Personal Reference #2
Name
*
First Name
Last Name
Relation to you:
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Agreements and Signature
What is your plan if you become unable to care for your pet?
*
Are you prepared to license your new dog or cat if your town requires it?
*
Yes
No
Do you agree to provide any necessary medical treatment at your own expense?
*
Yes
No
Applicant Signature
*
I understand an application does not guarantee adoption. We reserve the right to refuse any adoption. Applications will be processed and suitable homes will be contacted in a timely manner to schedule a meet and greet.
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
Should be Empty: