Oak Ridge Animal Shelter Adoption Application

Adoption Application
Thank you for your interest in adopting one of our available pets! Please answer all questions. This information is important to ensure that the adoption is in the pet’s best interest. We hope to help you find a pet that is well suited to your lifestyle.

To qualify for adoption, you must:

• Be 18 years or older and have a valid driver’s license or identification card stating your current address

• Have the knowledge and written consent of a landlord and all pet deposits paid prior to adoption (if relevant)

• Be able and willing to spend the time and money necessary to provide medical treatment, proper nourishment and care, and training for a pet – including yearly vaccines, monthly
flea/tick medication, and heartworm prevention.

Please note: We reserve to right to refuse adoption to anyone. Please be advised that we will not adopt to persons who mislead or fail to provide accurate information on this application. All households who have surrendered an animal are ineligible to adopt from us for one calendar year afterwards. You will be notified if your application has been approved.

*All questions are required when applicable.
Name of the pet(s) you are interested in: name*
Household Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number
Please enter a valid phone number we can reliably reach you at.
Cell Phone Number
Please enter a valid phone number we can reliably reach you at.
Spouse/Partner's Name

First NameLast Name
Email*
example@example.com
DOB*

MonthDayYear
Date
ID/Driver's License #*
State Issued*
Are you currently (check all that apply):*

Employed full timeEmployed part timeStudentRetiredOther
How many other adults live in your home?number*
Please list their names and ages: name/age
How many children live in your home? number*
Please list their ages: ages
Are all members of your household aware of and in agreement with this adoption? If not, please list who is not in favor of the adoption: name/relation*
Do you (check one):*

Own your homeRent your home
Is your home a (check one):*

HouseCondoApartmentOther
Name of homeowner, if not self (*required, if applicable): name/relation
Homeowners phone number:###-###-####
Name of Landlord (*required, if applicable):

First NameLast Name
Landlord's Phone Number (required, if applicable)
Please enter a valid phone number.
Does your lease allow pets? (check one):

YesNoDon't know
Do you have a fenced yard? (check one):*

YesNo
Type of fence: material
Height, in feet: number
Adoption Information
Why do you want to adopt this pet(s)?*

Love animals, want to help a pet in needCompanionshipWant to breedTo teach children to care for another creatureMouse control for the home and/or propertyCompanion for another petGift for someoneIf a gift, for whom?
If interested in a dog, what level of exercise do you prefer?

Couch potatoShort walksVigorous walksHiking/jogging
Do you have any preferences regarding the following traits? Answer all that apply:
Male or female?     preference
Long or short hair?     preference
Hypoallergenic?   preference
Age?   preference
Breed?   preference
Color?   preference
Size/weight?   preference
Please specify/other:      preference
Vet Care
Are you willing to provide vet care for your new pet? (check one):*

YesNo
What is your estimate of the cost for annual routine vet care for the pet you wish to adopt?*
Please provide a description of what you consider to be routine vet care:*
Who is your current or most recent veterinarian? (required, if applicable)*
Current Pets
How many pets do you currently own?*

Please list all current pets:

	Name	Species/Breed	Age	Spayed/Neutered:
Pet 1:
Pet 2:
Pet 3:
Pet 4:
Pet 5:
Pet 6:

Please list additional pets that live in your home that are not owned by you:

	Owner’s name (first and last)	Pet’s name	Species/breed:	Veterinarian they use:
Pet 1:
Pet 2:
Pet 3:

Do your pets wear identification tags?*

YesNoN/A
Are your pets vaccinated annually?*

YesNoN/A
Do you use heartworm preventative regularly?*

YesNoN/A
Do you use flea/tick preventative for your pets?*

YesNoN/A
Have your cats been tested for FIV/FeLV?*

YesNoN/A
Where do you keep your pets during the day?*
Where do you keep your pets at night?*
If applicable, how often will you allow your cats outside?*
If you have no current pets, when was the last time you had a pet?*
What was the name of your last pet and their breed?
New Pets
How will your dog be kept when outdoors? (check all that apply):

Tie out/chainGarageN/A, indoors onlyFenced yardInvisible fenceLeash walksLoose to roamOutdoor penOther
If you answered “loose to roam,” could you please explain:
How long will you keep the pet you are planning to adopt?*
If you move, what will you do with your pets?*
For cats, what are your intentions regarding declawing? Check all that apply:

Declaw immediatelyRegular nail trimsTrain to use scratching postDiscourage inappropriate scratchingWait and see if declawing is necessaryWhat is declawing? Could you please give me more information?N/AOther
What would cause you to return the pet in the future? Check any that apply:*

Can’t housebreak the petPet chews or is destructivePet bites someoneDoesn’t get along with other petsToo much energyPet develops medical problemsCan’t afford the petChange in relationship, new partner doesn’t like pet, has allergies, etc.New babyLife change, such as new job, international travel, etc.Other
Any additional information you would like us to know about you?
The following statements are true to the best of my knowledge. I am authorizing this as my signature: (sign below)*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Adoption Application

Household Information

Adoption Information

Vet Care

Current Pets

New Pets