Pre Adoption Application
Applicant's First Name
*
Applicant's Last Name
*
Email Address
*
Please enter correctly as this is the main way we will contact you
State
*
City
*
Street Address
*
Apartment Number (if applicable)
Zip Code
*
Phone Number
*
Please use the following format 248-555-1212
Alternate Phone Number
Date of Birth
*
How did you find out about us?
Petfinder
Internet Search
Family/Friend
Staff/Volunteer
Facebook/Twitter
Other
Animal you are interested in adopting
*
Alfred (Dog - D2198)
Carlton (Dog - D2196)
Chakra (Dog - D2139)
Chrissy (Dog - D1010)
Cosmo (Cat - C959)
Dice (Dog - D2175)
Gilligan (Dog - D2202)
Graycie (Cat - C960)
Howdy (Dog - D2191)
Joshua (Dog - D2194)
Lord Shiva (Dog - D2184)
Lulu (Dog - D2197)
Sadie (Dog - D2206)
Shadow (Dog - D2066)
Star (Dog - D2067)
Stryker (Dog - D2039)
Tiana (Dog - D2167)
Have you applied anywhere else for a pet?
*
No
Yes
If yes, where else have you applied for a pet?
Is this pet for you or someone else?
*
Myself
Someone else
Do you own other pets at the current time?
*
No
Yes
If yes, please list their names, breeds, and ages.
Are all of your pets spayed/neutered/fixed?
*
Yes
No
N/A
How many pets have you owned in the last 5-10 years?
*
Where any of your current or previous pets rescues?
*
Are your pets current on their vaccinations?
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No
Yes
Have you ever turned your dog or cat into a shelter?
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No
Yes
If yes, please explain?
Veterinarian's Name
*
If you have never owned a pet please tell us where you would go.
Veterinarian's Address, City, State, and Zip Code
*
Again if you have never owned a pet please list where you would go
Veterinarian's Phone Number
*
How do you feel about having pets spayed/neutered?
*
Agree
Disagree
Not Sure
Are you familiar with heartworms and heartworm prevention?
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No
Yes
If you have pets, how do you think they will they adjust to a new pet in the house?
*
Were any of your pets obedience trained?
*
Yes
No
N/A
If you answered "other" above, please explain here:
Please describe in detail what type of pet you are looking for to include breed(s), weight limit, age range, gender preference, energy level etc.
*
Do you own or rent your home?
*
Own
Rent
Someone else owns the Home
Someone else rents the Home
Please select your current residence type.
*
House
Apartment
Condo
Townhouse
Mobile Home
Other
If you answered "other" above, please explain here:
How long have you lived at this address?
*
Less than one month
1-2 months
3-6 months
6-9 months
9-12 months
1-2 years
3-5 years
6-10 years
10 + years
Do you plan to move soon?
*
No
Yes
Please list the ages & relationship of those who live in your home.
*
Is everyone in your household aware that you are planning to adopt a pet?
*
Yes
No
N/A
Does anyone in your household have allergies to dogs/cats?
*
Yes
No
Possibly
N/A
Employment Status
*
Full-Time
Part-Time
Retired
Work from Home
Stay at Home Parent
Student
Unemployed
Other
If you are employed, what is your current occupation?
On average, how many hours per day will your pet be left alone?
*
How much do you think the annual medical bills will be for your pet?
*
About $100
$100 - $200
$200 - $300
$300 - $500
$500 +
What would you do if the bills went over this amount?
*
Will this pet be predominantly living inside, outside, or both?
*
Inside
Outside
Both
Do you have a completely fenced-in yard? If so, what kind of fence?
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Wood
Chain Link
Electric
Plastic
Iron
Other
I do not have a fenced yard
If you answered "other" above, please explain:
If you do not have a fenced yard, how will you provide exercise?
*
Are there times when the animal will be tied/chained up?
*
Yes
No
N/A
If yes, when will they be tied/chained up?
Where will the animal sleep?
*
In bed with me
In bed with my child
In a dog / cat bed
In a kennel / crate
Wherever he or she likes
Outside
Other
If you answered "other" above, please explain:
Will the animal spend any time in the garage?
*
Yes
No
N/A
If the animal will spend time in the garage, please explain when/why:
How will you handle housebreaking?
*
How will you handle destructive behavior?
*
Will you keep the animal up-to-date on vaccinations and heartworm preventative?
No
Yes
If no, please explain:
Are you willing and able to exercise the dog on a regular basis?
*
Yes
No
N/A
If yes, what is the method of exercise?
*
Walking
Running
Dog Park / Dog Run
Other
If you answered "other" above, please explain:
Have you ever been convicted of abuse or neglect of a child or animal?
*
No
Yes
If yes, please explain:
What arrangements will you make for the care of your pets in case of an emergency?
*
Leave with family/friend
Boarding
Pet Sitter
Take with me/us
Other
If you answered "other" above, please explain:
What will you do with the animal when you go on vacation?
*
Leave with family/friend
Boarding
Pet sitter
Take with me/us
Other
If you answered "other" above, please explain:
For what reason(s) would you consider returning/giving up the animal?
*
What would you do with your animal if you had to move?
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Take him / her with me
Give to family or friend
Return to shelter
Other
If you answered "other" above, please explain:
Are you willing to take responsibility for this animal for the next 10-20 years?
*
No
Yes
If no, please explain:
Please check the main reason you plan to adopt a pet:
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Companion
Family Pet
Child's Pet Guard Dog
Companion for another pet
Other
If you rent, can you provide documentation showing your lease allows pets?
Yes
No
Unsure
N/A
Please provide your landlord's name and phone number
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal.
*
Yes
No