Are you 18 years of age or older? *
Please Select
Yes, I am at 18 years old or older
No I am younger than 18 years old
Date: *
Please select today's date.
Is there a specific animal you are interested in? If yes, please state the name of the animal. *
Is there an animal currently at the shelter you are applying for? If so, state their name.
What type of animal are you looking for? *
Which type of animal are you interested in adopting?
Please Select
Dog
Cat
Other
What age range are you interested in? (Please select all that apply) *
Please select all age groups, you would consider adopting.
Under a year
1-3 years
4-6 years
7 and up
What size of animal are you looking for? *
If you are looking to adopt a dog, please select what weight range you would prefer the dog to be when fully grown. If you are looking to adopt a cat, please select small.
Small (under 20lbs)
Medium (20lbs to 60lbs)
Large (60lbs and up)
First Name: *
What is your given name?
Surname *
Last name of the person applying.
Name(s) of ALL adults in the household: *
Please state your name and list all adults (18 and over) residing in your household.
Street Address: *
What street do you live on?
Town/City: *
What city or town do you live in?
Province: *
Which province are you located?
Postal Code: *
What is your postal code?
Phone #: *
List a reliable number you can be reached. If you have an alternate number, please state that as well.
Alternate #:
If you have another number you can be reached at, please type it here.
Email Address: *
List an email address you can be reached at.
Are You: *
Select the option from the list that best describes your situation.
Please Select One
Attending School
Working
Retired
Stay At Home Parent
Disability
Occupation(s) of ALL adults: *
What is your current occupation and the occupations of ALL adults in your household.
Living Arrangements: *
Select the option from the list that best describes your current living situation.
Please Select One
House
Apartment
NL Housing
With Parents/Family
Do you: *
Select if you are currently own your home or if you are renting.
Please Select One
Rent
Own
Rent to own
If living with parents/family please provide a number they can be reached:
How long have you been living at your current residence? *
Landlord's Name:
Provide us with your landlord's name.
Landlord's Number (mandatory if you are renting):
Provide us with a number your landlord can be reached.
SECTION 2
Number of adults in your home: *
How many people over the age of 18, are currently living in your household?
Number of children in your home: *
How many children (17 and under) are currently living in your household?
Ages of children: *
List the ages of any children living in your household.
Who will be responsible for feeding the pet? *
Name the person or persons, responsible for feeding your new pet.
Who will be responsible for the training of the pet? *
Name the person or persons, responsible for training your new pet.
Please select all the reasons for wishing to adopt: *
Select the reason or reasons, that best match why you are wanting to adopt a new pet.
Companion
Gift
For a child
Hunting
Guard dog
To Breed
Are ALL adults in your home, in agreement to adopt a pet? *
Are all the adults in your household, wanting or okay with, adopting a new pet?
Have you adopted an animal from the S.P.C.A. before? *
Have you adopted from any S.P.C.A. recently or in the past?
If yes, which branch?
Which S.P.C.A. have you adopted from?
Do you still own this animal?
Do you still own the animal you adopted?
If no, why?:
What is the reason you no longer have the animal? Death, re-home, sent back to the shelter, etc.
Please fill out the following for each pet you currently have or have had in the past 10 years: Pet 1:
Name:
Name of the pet.
Breed:
What breed was/is this pet. Cat, dog etc. Mixed, purebred etc.
Age:
How old was/is this pet?
Sex:
Was/is this pet Male or Female?
Select One
Male
Female
Where was/is the pet kept?
Was/is this pet kept inside the home, outside, both?
Was/is your pet fixed?
Was/is your pet spayed or neutered?
Select One
Yes
No
If you no longer own this pet, please state why:
What is the reason you no long own this pet? Death, re-homed etc.
Pet 2:
Name:
Name of the pet.
Breed:
What breed was/is this pet. Cat, dog etc. Mixed, purebred etc.
Age:
How old was/is this pet?
Sex:
Was/is this pet Male or Female?
Select One
Male
Female
Where was/is the pet kept?
Was/is this pet kept inside the home, outside, both?
Was/is your pet fixed?
Was/is your pet spayed or neutered?
Select One
Yes
No
If you no longer own this pet, please state why:
What is the reason you no long own this pet? Death, re-homed etc.
Pet 3:
Name:
Name of the pet.
Breed:
What breed was/is this pet. Cat, dog etc. Mixed, purebred etc.
Age:
How old was/is this pet?
Sex:
Was/is this pet Male or Female?
Select One
Male
Female
Where was/is the pet kept?
Was/is this pet kept inside the home, outside, both?
Was/is your pet fixed?
Was/is your pet spayed or neutered?
Select One
No
Yes
If you no longer own this pet, please state why:
What is the reason you no long own this pet? Death, re-homed etc.
Pet 4:
Name:
Name of the pet.
Breed:
What breed was/is this pet. Cat, dog etc. Mixed, purebred etc.
Age:
How old was/is this pet?
Sex
Was/is this pet Male or Female?
Select One
Male
Female
Was/is your pet fixed?
Was/is your pet spayed or neutered?
Select One
No
Yes
Where was/is the pet kept?
Was/is this pet kept inside the home, outside, both?
If you no longer own this pet, please state why:
What is the reason you no long own this pet? Death, re-homed etc.
ATTENTION: If you have previous history at a veterinary clinic, please call them to give them permission to discuss your vet records with our shelter, NO applications will be processed without your previous vet history confirmed.
Which Vet Clinic currently looks after your pets? *
Where do you take your animal(s) for medical care? If you have no previous vet history write N/A.
Do you understand that you MUST call your vet clinic that looks after your animal(s) and give them permission to share your information with the Gander and Area SPCA? *
Yes, I understand if I do not call my vet clinic my application will NOT be processed
I do not have a current or past vet
Whose name will the animal(s) file be under at this vet clinic? (If unsure please call the clinic and confirm) *
Please list any other vet clinics your present and/or past animals have gone to. *
Where have you taken your animal(s) in the past for medical care? If you have no previous vet history write N/A.
Is your pet(s) up to date on their vaccinations? *
Is your current pet up to date on his/her needles?
Have you had a pet die of a contagious disease or unknown cause in the past three months? *
Have you had a pet die recently for an unknown reason or from a contagious disease?
Have any of your pets died as a result of being hit by a vehicle? *
Have any of your past pets been killed by a vehicle?
If you move, what will you do with your pet? *
What will happen to your pet if you have to move?
If you go on vacation, what will you do with your pet? *
Where will your pet stay while you go on vacation?
Are you willing to accept the financial responsibility of an unexpected/required medical expense? *
Do you understand that unexpected medical expenses may arise and are you prepared to pay for the vet fees?
If you are not working, how will you finance the spay/neuter? *
If you aren't working when it is time for the spay/neuter of your pet, how will you find the money to fund it?
SECTION 3
Are you willing to spay/neuter this pet in the REQUIRED time given? *
Are you willing to have the pet spayed/neutered within the time frame given to you at the time of adoption?
Are you willing to maintain your pets booster shot? *
Will you be keeping your pet up to date on it's required needles?
Where will your pet stay during the day and during the night? *
Where will your pet be spending most of the daytime and nighttime?
Are you prepared to allow an adjustment period of at least one month? *
Are you okay with giving your new pet time to adjust to his/her new home?
Are there people with allergies living in your home? *
Does anyone in your home have allergies to animals?
Are you prepared to deal with any accident your pet may have/make in your home? *
Your new pet may have an "accident" or make a mess in your new home, are you okay letting the pet adjust to the new environment and realize training might be required?
Do you understand that once you adopt this pet there will be NO REFUND? *
If you decide you can not keep this pet, any adoption fee you have paid, will not be refunded.
You are only required to fill out the next four questions if the application is for a dog/puppy
Do you have a fenced in yard?
Do you have a fenced in yard for your new dog?
Who will be home during the day with this pet?
Who will be around during the day with or to check on the dog/puppy?
Where will your pet stay when left alone?
Where will you dog/puppy be kept while you are out? e.g. Kennel, restricted to a room, outside etc.
Will you have your pet groomed or nails clipped when needed?
Are you willing to keep your dog/puppy's nails trimmed and to have him/her groomed when needed?
REFERENCES
Please supply THREE references; one family member (other than someone living in your household), and two non family members (co-workers, friends etc.)
Name: *
First and last name of reference.
Relationship to him/her: *
What is your relationship to this reference? e.g. sister, friend, co-worker etc.
Address: *
Where does this reference live?
Phone #: *
What is a reliable number to reach this reference?
Name: *
First and last name of reference.
Address: *
Where does this reference live?
Relationship to him/her: *
What is your relationship to this reference? e.g. sister, friend, co-worker etc.
Phone #: *
What is a reliable number to reach this reference?
Name: *
First and last name of reference.
Address: *
Where does this reference live?
Relationship to him/her: *
What is your relationship to this reference? e.g. sister, friend, co-worker etc.
Phone #: *
What is a reliable number to reach this reference?
By signing below and clicking accept, I certify that the information I have given is true and that by any misrepresentation of the facts may result in losing the privilege of adopting a pet. I understand that the Gander and Area S.P.C.A. has the right to deny my request to adopt an animal, and I authorize the investigation of all statements made on this application.
Additionally if my application is incomplete I am aware it will not be reviewed.
Do you accept the terms stated above: *
Type yes or no. If you are using a touch screen device, please sign above the line. If not, leave blank.
Applicant Signature
If you are using a touch screen device, please sign here, if your are not leave it blank.
Clear
