LCAS Adoption Application

Lost Cove Animal Sanctuary is dedicated to finding the very best homes for our rescue animals. To meet this goal, we carefully scrutinize all applications. We check all veterinarian, landlord, and personal references. If you are serious about adopting, please complete the application IN FULL. Please note that since our mission is to reduce the pet overpopulation problem, we will not adopt to homes with intact pets unless there is a reasonable explanation as to why the animal remains unaltered (i.e., being shown in conformation, medical, etc.) Thank You.

WARNING: USING YOUR BROWSER'S (SAFARI, IE, CHROME, FIREFOX, ETC) BACK BUTTON MAY RESULT IN ALL DATA BEING LOST.

PLEASE USE THIS FORM'S NEXT AND BACK BUTTONS AT THE BOTTOM OF THE APPLICATION. FAILURE TO DO SO MAY REQUIRE YOU TO START FROM THE BEGINNING.

Applicant Details

Please CHECK or FILL IN all choices throughout this questionnaire.

ALL questions must be filled out. If the question does not apply to you (work, renting, pets, children) then please put N/A or NONE. Thank you!

Date *

Date Date Picker Icon

Are you interested in : *

Adoption Fostering

Which animal are you interested in?

Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State
Zip Code	Country

County *

How long at this address: *

Less than 1 Year 1-5 Years 5-10 Years 10+ Years

Phone Number (Home): *

Area Code and Phone Number

Phone Number (Mobile): *

Area Code and Phone Number

E-mail *

example@example.com

Occupation

Company Name *

If you do not work, please put N/A

Work Address *

If you do not work, please put N/A

Work Phone *

If you do not work, please put N/A

Are you: *

Married Single Living with roommates

What is your age group: *

Under 21 21-40 40-60 60+

How many adults in household? *

Number Only

How many children in household? *

If you do not have children, please put 0

Ages and Gender of Children in Household (click + sign after each name) (if none, put "NONE" and click the + sign): *

Do you Rent/Own? *

Rent Own

I/We live in a: (click on box for options) *

If you rent, do you have your landlord's permission to keep a dog? (click on box for options) *

Landlord's Name *

First and Last-If you do not rent, please put N/A

Landlord's Phone Number *

If you do not rent or have a landlord, please put N/A

Landlord's Address *

If you do not rent or have a landlord, please put N/A

Please list all animal(s) you have had for the past 5 years: (Click Enter after each animal) **If you have not had any animals in the last 5 years, put NONE and click ENTER** *

If you no longer own any of the animal(s) listed above, please explain: *

Where are they now: lost, died/euthanized, given away, etc? If they have passed, how did it happen and why? If given away, why and to whom?

Do you have a regular Veterinarian? *

Yes No

Clinic Name *

Put NONE if you do not have a regular Veterinarian

Clinic Phone Number *

Put NONE if you do not have a regular Veterinarian

Clinic Address *

Please put NONE if you do not have a regular Veterinarian

What Name Are Your Pets Listed Under At The Clinic? *

If you do not have a regular veterinarian or clinic, put N/A

Who Administers Your Pets Vaccinations and Heartworm Test? *

For Example: My Veterinarian OR Tractor Supply PetVet Clinic, etc. (If you do not have any pets put NONE)

Do you have a completely fenced in yard? *

Yes No

Do you have a kennel run/dog lot? *

Yes No

Please provide more information about your fence/kennel run/dog lot: *

Type of fence/kennel run: wood, privacy, chain link, hog wire, etc. Height AND approximate size of area: 6 feet and 10'x10' run, etc.

Do you have a suitable dog crate? *

Yes No

If so, what type? *

plastic, mesh, wire, etc

My new dog will be housed/living in: (Please click on the box for options) *

Please specify where your current animals are housed: *

Specify EACH type of animal and where EACH of them are housed. IF you do not have any animals, please put N/A

How many hours per day will the new dog be left alone? *

Use numbers only

Where will the new dog be housed when you leave during the day (NOT vacation)? *

Please use the previous housing options as your choices-You can choose more than one option (House and Crate).

LCAS Adoption Application

Applicant Details

Please provide a NON-FAMILY reference

Please provide a FAMILY reference:

Terms and Conditions