Animal Adoption Application ARP

Name of animal you wish to adopt.*

Your name*

First & Last Name

Driver's License #*

First & Last Name

Your Address*

Street Address

Street Address Line 2

CityState

Zip Code

Your Email*

Your Phone Number*

Area CodePhone Number

Phone Type*

CellHomeWork

Names and ages of all permanent residents of your home (adults/children)*

Please list any pets currently living in your home, and if they are vaccinated and altered.

Vet reference (please call your vet and give notice that we will call. If you have not been to a vet before, please register with one soon.)*

Vet name, address & phone number

Please list two (2) references. One personal one business is preferred and phone #.

Are you planning to move in the near future?*

YesNo

If moving soon, to what city/state?

When will you be ready to adopt this animal?*

Is anyone in your home allergic to the animal you're planning to adopt?*

YesNoYes, but it is tolerable for them and they are OK with it.

Are you familiar with the breed?*

YesNo

Have you ever adopted before?*

YesNo

If you answered Yes to the above please give details of the adoption. And do you still have the pet?*

Have you ever rehomed or returned a pet to a shelter?*

YesNo

If you answered Yes to the above please give details.*

You live in a:*

Do you rent or own this property?*

RentOwn

If you RENT please provide name of Landlord and phone number.*

Does your Landord allow pets and how many?*

Yes 1-3 dogs/catsYes more then 3 dogs/catsNo pets allowed

May we visit your home?*

YesNo

If you rent, you must give the person you are adopting from a written letter from your landlord or a copy of the section of your lease stating that you are allowed to have this type of animal and showing any limitations.

If you live in a condo or townhome, you must show us written proof that you are allowed to have this type of animal there and show any restrictions.

If you live in a HOA/POA is this type of animal allowable? We will need to see your governing documents or a letter from your HOA/POA Board of Directors of approval. We will assist you with this if needed.

Do you have a yard?*

Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)

Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.

Please be aware that dogs/cats given as gifts for the holiday season are usually returned to shelters or given to pounds after the New Year's. With this in mind, please make sure that any animal you are adopting will be a permenant resident.

Are you willing and capable of all expenses including medical treatement, prevention care and grooming for your pet?*

YesNo

Are you willing to give the pet adequate time to adjust to their new home and surroundings? (this could take weeks to months)*

YesNo

You agree not to chain an animal outside or keep as an outside pet. *

YesNo

If applicable, will your children be taught how to play gently and kindly with this animal?*

YesNoNo children

Vet bills can be expensive. How do you plan on paying them? (IE: Pet health insurance)*

Additional reference (if desired)

Do you have any additional comments, questions or concerns?*

Our adoption fees vary based on the vetting and care provided for the pet while in our care. We also assist with transporting your new pet if you are not able to pick up, what is the amount you are willing to pay for transit?*

What is your preferred method of paypment?*

Credit CardPaypalOther/None

By checking the box below, you understand the terms of this form and adoptee. You hereby agree that you will not use this animal in any sort of fighting, breeding, or cruelty. You will love and care for this animal for the rest of its life, and you are ready to commit to that. You also agree, that if for any circumstances you can no longer provide love and care for this animal, you will contact an admin of the group and explain your situation so RTWC can rehome the pet or put in foster care until a new adopter is found. Under NO circumstance is the pet to be rehomed by you or taken to any shelter for any reason.

I understand the above, and have tried to the best of my knowledge to make sure all information is correct.

Adopter's Signature*

Signature date*

Thank you for taking the time to submit this form. Please feel free to contact Roman's Travel with Care at RomansTravelwithCare@gmail.com. After you click the Submit, you will be redirected to the main page, and you will also recieve a confirmation email. Thank you!