Johnston County Animal Protection League Adoption Application

ADOPTION APPLICATION

website: jcapl.org | ph: 919-989-7601 | fax: 919-300-5524 | email: help@jcapl.org | mailing address: PO Box 607, Smithfield, NC 27577
Pet Information

Note that adoption fees are $150 for cats/kittens, and $250 for dogs/puppies
Name of pet you wish to adopt
Dog or Cat?
If more than one or you have not picked out an animal yet, please provide info here.

First Name
Last Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Driver's License #
E-mail
Primary Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
Additional #

Area CodePhone Number
Ages of children in home
Do you own or rent your home?
If renting, how many pets are allowed
Landlord Contact Information
Will need a copy of lease, or landlord/rental contact information
Copy of lease agreement (if available)

Browse Files

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Pets you own now, or have owned in the past 5 years

Rows	Name	Dog/Cat/Other	Age	* Is pet still with you (Y/N)?	*Spayed/Neutered (Y/N)?
Pet #1
Pet #2
Pet #3
Pet #4
Pet # 5

* If any of the pets above are no longer with you, explain why.
* If any of the pets above are not/were not spayed/neutered, explain why.

Do you have a veterinarian?
Who is your veterinarian?
Veterinarian Phone
Veterinarian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are your current pets up to date on yearly vaccinations?
* If no, why?
Please note, JCAPL must speak with your veterinarian before committing to an adoption. Many veterinarians require permission by the owner before disclosing pet care history. Please contact your veterinarian and inform them that a representative from JCAPL will be contacting them.
If no veterinarian, list the name and phone number/email of two individuals as pet references.
REFERENCE #1
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
REFERENCE #2
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com

Have you owned any declawed cats?
Do you plan to declaw this cat?
Do you plan to let this cat outdoors?

This document is an application for adoption and completing does not constitute a promise of pet adoption. The JCAPL screening process can take one or more business days to obtain approval.

All animals available for adoption will be spayed/neutered prior to going to their new home or in some cases, the new family will be responsible for transporting to spay/neuter appointment. JCAPL will always work as quickly as possible to have pets join their new families.

Completing this application means you are 18 years or older, giving JCAPL and its representatives the right to check any references given, property ownership and completing a home check for specific breeds before application approval.

Pets are not “adopted” until the JCAPL Adoption Agreement is signed, the adoption fee is paid, and the pet leaves with its new owner. Adopted pets may be returned to JCAPL within 7 calendar days for a full refund. After 7 days, JCAPL will accept returned pets, but no refund will be given. JCAPL reserves the right to refuse adoption for any reason.

I understand and accept the terms of this application
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please allow 48 hours for a reply to your application submission.
Entering my name indicates my agreement to the terms and conditions above.
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