Adoption Application EBARR

Adoption Application

In order to be considered for an adoption today, you must:

*Be 18 years of age
*Have the knowledge and consent of all adults living in your household
*Have a valid ID with current address
*Have landlord’s name and telephone number (or lease)
*Understand that EBARR has the right to deny your application (based on the policies set by the board of directors.)

Your Name

First NameLast Name

What animal are you adopting? (Species, name)

Your Physical Home Address

Street Address

Street Address Line 2

CityState

Zip Code

Your Email

Alternate Email

example@example.com

Your Phone Number

Area CodePhone Number

Alternate Phone Number

Area CodePhone Number

Phone Type

What type of pet are you looking for? (Check all that apply)

Occupation and where employed:

Do you want a particular breed? If yes, what breed?

Do you want this pet for: (Check all that apply)

Describe the temperament/personality of an ideal animal:

How many days a week might this pet be without human companionship?

On those days, for approximately how many hours will the pet be without human companionship?

Please describe a normal day in your household?

Where will your pet be kept during the day and/or night? (Check all that apply)

Do you plan to let your cat outdoors?

Do you prefer a de-clawed cat?

Where do you live?

Do you rent or own this property?

If rent, please provide your Landlords name and phone number:

Does your landlord allow pets?

Other

Is there a deposit required?

Other

Please Provide the following information about your household: Number of adults: Name and ages of adults and children who live in the house:

Is anyone in the house or family allergic to animals:

What will you do if someone in the family develops an allergy?

Are you aware of breed restrictions with your Homeowners and/or Renters Insurance?

Do you have a fenced yard?

If fenced, please describe the height and type:

How much do you anticipate spending yearly to feed, vaccinate, license and providing medical care for your new pet?

What type(s) of pets do you own or have owned in the last 5 years?

Other

Where are your pets now?

List all Animals currently residing in the home: Species, Breed, Sex and age.

Who is (was) your Veterinarian for the above animals?

Provide Name and Phone number

Some animals require both mental and physical stimulation such as daily walks, playtime, and enrichment activities. How can you help provide these for your pet?

Would you allow a Rep. from EBARR to visit your home prior to the adoption being approved?

Do you realize that a dog or cat may live 15 or more years?

Are you willing to make the 15-year commitment?

It may take your new pet two or more weeks to adjust to its new home,especially if other pets are involved. Are you prepared to allow this much time?

If you go away for a few days, who will take care of your pet?

If you can no longer care for your pet, what is your plan?

If your pet becomes ill what is your plan?

If your animal develops behavior issues what is your plan?

Where do you plan on keeping your animal during loud environmental events (4th of July, New Years Eve, etc)?

EBARR regularly adopts out large breed and untrained puppies. As an adopter, we expect that you train this dog either at home, with a trainer, or in a training class. Are you willing to provide this training?

Please provide initials

EBARR regularly adopts out puppies: Please understand taking care of a puppy is a lot of work, after puppyhood the dog goes into adolescence. This is also a time when a dog needs a lot of attention and exercise. By signing below, I agree if adopting a puppy to give the animal the attention it needs during these challenging times.

Please provide initials

EBARR is trusting that you will provide care and love for this pet throughout its life. If you find yourself challenged, you are required to reach out to us before it becomes a critical situation. We do our best to aid when unforeseen circumstances happen, and a family must return a pet. Please understand that to rehome a pet it could take months or even a year, and EBARR will ask that you foster until rehomed. EBARR animals are not allowed to be rehomed without reaching out to us first.

Please provide initials

EBARR adopts a pet to a specific person: if you feel you must re-home, you agree to do the following: 1. Inform the rescue of your need. 2. Provide information of the new owner so the microchip can be changed accordingly. EBARR is trusting that you will provide care and love for this pet throughout its life. If you find yourself challenged, you are required to reach out to us before it becomes a critical situation. We do our best to aid when unforeseen circumstances happen, and a family must return a pet. Please understand that to rehome a pet it could take months or even a year, and EBARR will ask that you foster until rehomed. EBARR animals are not allowed to be rehomed without reaching out to us first. EBARR animals are not allowed to be given as gifts unless disclosed at adoption. By signing below, you are agreeing to all statements above.

Please provide initials

By signing below, I certify that the information I have given is true and correct. I recognize that any misrepresentation of the facts may result in my losing privilege of adopting a pet. I authorize investigation of all statements on this application. I understand that this application is property of EBARR.

Thank you for taking the time to submit this form. Please feel free to contact me (the person you are adopting from) or anyone from the organization. After you click the Submit, you will be redirected to the main page, and you will also recieve a confirmation email. Thank you!

Signature date

Signature

East Bay Animal Rescue & Refuge (EBARR)