Adoption Application

Adoption Application

Thank you for your interest in adopting through our rescue. Please fill out this application in it's entirety. We will email you a response within 24 hours of submission.
Name*

First NameLast Name
Spouse/Partner's Name

First NameLast Name
Cell Phone Number*

Area CodePhone Number
Home Phone Number

Area CodePhone Number
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
cell phonehome phoneemail
yesno
Rent - Apartment/CondoRent - Single Family HomeRent - Multi Family HomeOwn - Apartment/CondoOwn - Single Family HomeOwn - Multi Family Home
Do you have a fenced in yard? (specify height and type)
Occupation and Employer (specify employer name, address, phone number, and job title)
Landlord's Contact Information (full name, address, and phone number)
Personal Reference (full name, address, phone number)
Veterinarian Reference (name, office name, phone number, current or past)
Do you live alone?
How many adults live in your home?
Do children live in your home? If so, please list ages.
Any allergies in your home?
How many dogs do you currently own?
Are they spayed or neutered?
Are they current on vaccinations?
How many cats do you currently own?
Are they spayed or neutered?
Are they current on vaccinations?
Have you ever adopted from another rescue or shelter?
List the animals you have previously owned
puppydogkittencat
malefemaleeither
Is there a particular dog or cat you are applying for? Please list the names. If you would like suggestions, we would be happy to help.
Preferred Breed
Less than 10 pounds10-25 pounds25-40 pounds40-60 pounds60+ pounds
yesno
yesno
What is your reason for adopting?
Is your entire household committed to adopting? Please state any concerns.
Have you ever surrendered a pet to anyone? If yes, please explain.
Has a pet every disapeared, been killed, or injured while in your care? If yes, please explain.
What would you do if your new pet chews your belongings or shows destructive behavior?
0-2 hours2-5 hours5-9 hourslonger
Where will your new pet stay when everyone leaves the house?
Where will your new pet sleep?
How will he/she be exercised and how often?
How long do you feel a new pet should be given for an adjustment period?
yesno
yesno
yesno
yesno
Do you acknowledge that there can be disagreements and you will strive to ease the transition? Will you provide care and guidance as needed? Note: small dissagreements are expected and typical behavior when a new pet is brought into a home where you already have a dog or cat. There can be fear and anxiety that you must be willing to work with during the transition time until everyone is comfortable in your home. This can take some time.
How did you find out about us?
Electronic Signature: Your electronic signature below serves as acknowledgement that this is a sincere inquiry, and that all information provided is true, correct and complete. On the Internet an Electronic Signature carries the same legal weight as if you were signing your name to a printed document. To complete this form, please provide your electronic signature below by typing your name in the box, then submit the form.
Thank you for your interest in adopting from our rescue. We will contact you within 24 hours. Feel free to email packleadersrescueCT@gmail.com to check the status of your application.
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Adoption Application

Thank you for your interest in adopting from our rescue. We will contact you within 24 hours. Feel free to email packleadersrescueCT@gmail.com to check the status of your application.