Adoption Application and Contract

ARK Animal Rescue and Adoption

Please don't think of any answer as good or bad, right or wrong. Answer honestly so that Ark can determine if the family/home life will fit the pet for whom you have applied. Ark reserves the right to require a waiting period for an evaluation period before adoption may be completed in order to process your application.

The adopting party must be at least 18 years of age to adopt a pet from Ark.

Select Pet Name
Type pet name(s) of others interested in.
Primary Adopter First Name *
Primary Adopter Last Name *
Secondary Adopter Full Name:
What is your street address? *
What is your city? *
What is your state? *
What is your zipcode? *
Cell Phone: *
Home Phone:
Email: *
Driver's License No. *
Select Choose File and Take Picture of your Driver’s License *
How did you hear about us/this dog? *
Please list names and ages (Jane Doe/25 yrs.) of all other parties living in the home.
Please indicate what best describes your current living situation. If you rent or are buying on a land contract, we will require permission from the property owner. It is your responsibility to obtain permission before adopting. *
Please describe: *
If you rent or are on land contract, please provide contact information for your landlord.
If less than 3 years at your residence, what was your previous address?
How long did you reside at this residence?
What will you do with your new pet if you move? *
Where will your new pet be kept during the day? *
Where will your new pet be kept at night? *
Where will your new pet be kept while not at home? *
Do you have a fenced yard or dog run? *
If you do not have a fenced yard or dog run, how will you keep your new pet from running loose? *
Are you financially prepared to provide the care and commitment? *
Have you ever brought an animal to our shelter or to any other shelter? *
If you have brought an animal to a shelter, please explain the reason. *
Please list the animals you have currently (ex. Bruno/dog) *
Are your pets up to date on all vaccinations? *
Are your pets spayed or neutered? *
Are you aware of the need for heartworm prevention? *
Do you agree to provide any and all veterinary treatment that my new pet may require throughout his/her lifetime? *
Please provide the names, addresses, and phone numbers of 3 references, with one being your past or present vet. You MUST call your vet and release your information to be shared with Ark when we call. *
Upon application you agree to a home visit that helps to ensure us that the pet is in a safe and happy environment. What time of day works best for you? *
We want you to understand that any time you adopt a pet from an animal welfare organization, you take a certain risk. There is always a chance that the animal is incubating a disease at the time of adoption and not showing any clinical signs. Since many of our animals are strays, it is impossible to tell where they have been and what they may have come in contact with. Therefore, an animal that appears healthy may have been exposed to disease. The vaccinations it receives will be ineffective in combating these diseases. Please have your new pet health checked within 7 days of adoption by a licensed veterinarian. We will only offer a refund or replacement for an animal diagnosed by a licensed veterinarian to have an incurable disease within 7 days of the adoption date. If you as the new pet owner elect to treat the pet's illness, without first consulting us, you will be responsible for any costs incurred in the treatment. To protect all animals involved, any dogs or cats currently owned or kept by the adopter must have current vaccinations before a new pet is placed in the household. We will not be held liable for any illnesses that may be passed from a newly adopted pet because an owned pet is not current on their vaccinations. We make no claims or representations as to the behavior, or the temperament of the animal(s) we place up for adoption. Since most of our pets have minimal behavior training, we expect the pet's new family to put forth a sincere effort to train their new pet. We will be happy to give you helpful training tips or advice. We do not give refunds for trainable behavior problems; you must be willing to work with your new pet and accept this responsibility. I certify that the information provided on the entire application is true and correct. I am also financially able to care for this animal. I will provide a loving, safe, healthy, and clean environment for the adopted pet. I know proper food and veterinary care can be costly and I am able to meet these requirements. I also give consent to my veterinary office and any and all individuals listed to release information to us regardless of the type of information. Furthermore, I understand that a visit to and inspection of my home may be required and also may be on a random basis following adoption. I hereby give my permission to forward the information contained in this application to any Ark Animal Rescue and Adoption, Inc representative or designated evaluator.
Please initial to consent and verify the above information. *
I agree that within 10 days of my application, if my references are not favorable, if my landlord states that it is not feasible to possess a pet, if upon inspection the information contained in the application is found to be false or incorrect, we request the return of the pet to our care. I will consider my adoption contract and/or this application void and will return the pet immediately to Ark. Ark is not required to disclose the reason for denial of this application and request for return of the pet to our care.
Please initial below to agree. *
Ark Animal Rescue & Adoptions, Inc. provides rescue and placement of pets that would otherwise be homeless. Adopting families acknowledge the commitment to provide safe, secure, affectionate, and healthy environments for these pets. Upon adoption of this pet the adopting party agrees as follows: 1. The adopting party represents that no member of the family has ever been charged with cruelty to animals. 2. The adopting party will keep the animal either as an inside house pet or in an outside area adequate for the pet's size and temperament. Furthermore, this animal will NOT be permanently restrained to a fixed object. 3. The adopting party will provide daily exercise for the pet in the form of a fenced area or walking on a leash (dogs in particular). 4. The rescued pet will never be used in any form of animal fighting. 5. The rescued pet will never be given, leased, nor sold to a laboratory or business. 6. A professional animal behaviorist will be consulted for any problems before giving up the pet. 7. A rescued pet, deemed suitable for adoption, will be RETURNED to Ark Animal Rescue & Adoptions, Inc. if adopting party is subsequently unable or unwilling to care for the pet. 8. The adopting party shall provide sufficient food, water, shelter, and reasonable medical care. 9. The rescued pet will not be neglected, abused, or treated cruelly and will not be the subject of experimentation. 10. In the event any of the terms of this agreement have not been fulfilled, the adopting party shall surrender custody of the pet to Ark Animal Rescue & Adoptions, Inc. should litigation be required the adopting party shall pay legal fees and court costs. 11. Ark Animal Rescue & Adoptions, Inc. does not warrant the temperament or behavior of the adopted pet, nor is it warranted to be free of any genetic or health defects. The selection of the pet is based upon the adopting party's own observation and judgment. Further, Ark Animal Rescue & Adoptions, Inc. is not responsible for any acts of the adopted pet while living with the adopting party.
Please initial to agree to the above conditions. *
Furthermore, I agree that I will take this pet into my possession at my own risk and at my sole discretion.
If the pet you are applying for is not fixed, you agree to have it spayed or neutered by (_________________________) (6 months of age). $175 (for puppies) or $75 (for kittens) will be rebated upon receipt of the procedure having been done. If the deadline is not met, Ark Animal Rescue & Adoptions, Inc. reserves the right to reclaim the pet.
Please initial below to agree. *
I acknowledge that I have read the entirety of this application and understand it.
Please sign your name (or names if there is a secondary adopter) to agree. *

A copy of your responses will be emailed to the address you provided.