Evergreen Paws Adoption Form

Potential Adopter Full Name*

First NameLast Name

E-mail*

example@example.com

Phone Number*

Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How did you hear about us?*

What is your 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?*

YesNo

If yes, for what reason?

Is everyone in household in agreement to adopting an animal?*

YesNo

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?*

YesNo

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 NameLast 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

Evergreen Paws Rescue Online Adoption Application Form