Evergreen Paws Rescue Online Adoption Application Form
Potential Adopter Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about us?
*
What is your age?
*
Please Select
17-25 years of age
26-36 years of age
37-45 years of age
>45 years of age
Adopting parents must be at least 17 years old.
Name of animal you wish to adopt? If you don't know, put n/a
*
Type of dwelling: (house, condo, trailer, apartment, etc)
*
How long have you lived there?
*
If adopting a dog, do you have a secure fence? If not, how do you plan to handle walking him/her multiple times per day? If adopting a cat, do you have a dedicated space for a litter box.
*
Have you ever had other animals before, if so what kind?
Have you ever had to give up a dog or other animal?
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Yes
No
If yes, for what reason?
Is everyone in household in agreement to adopting an animal?
*
Yes
No
How many other pets do you have and what kind of pets/breed are they?
*
Who will train, feed and exercise the animal?
*
Where will the animal be kept at night?
*
Will the animal be tied up?
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Yes
No
Who is your Vet? If you do not have one yet, let us know if you need a recommendation.
*
Please provide a reference that is not family member
*
First Name
Last Name
Reference Person's Phone Number
*
Please provide a link to your personal social media profile. This is only used so we can get a sense of you and your family.
*
I/we agree with the following statements
*
If we adopt an animal, we will provide professional vet care, a nutritious diet, and a loving home. This includes monthly heart-worm and flea preventative.
We also agree that we will return the animal if we can no longer keep it.
No member of our household has ever been convicted of cruelty to animals.
If we adopt a puppy/kitten under the spaying/neutering age, we agree to have them spayed/neutered once they become of age. Failure to do so can result in termination of this agreement.
Please verify that you are human
*
Signature
Submit
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