SparKy Adoption Application

Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Format: (000) 000-0000.

E-mail

example@example.com

Have you ever adopted from a rescue before?

If yes, what was the name of the rescue?

What animal are you interested in?

Are all of your pets spayed/neutered?

Other

Are all of your pets up to date on vaccinations?

Name of the vet you currently use?

Confidentiality of veterinary patient records.

In the state of Kentucky, a veterinarian may not release information concerning a client or care of a client's animal, except on the veterinarian's receipt of a written authorization or other form of waiver executed by the client.

Please contact your vet and give approval that they may release information to Saving Paws Animal Rescue of Kentucky (SPARKY) for a records check.

Do you have any children?

If so, what are their ages?

If you rent, landlord name and contact info:

Do you have a fenced in backyard?

Where will you be keeping this pet?

Pets you currently own?

Have you ever surrendered a pet over to a rescue and or shelter?

Experience with pets and other comments:

Adoption Application: