Adoption Application - Athens Animal Rescue Shelter
Applicant's First Name
*
Applicant's Last Name
*
Phone Number
Please use the following format 248-555-1212
Cell Phone Number
Email Address
*
What is the best way to contact you?
Cell Phone
Home Phone
Email
Street Address
*
City
*
State
*
Apartment Number (if applicable)
Zip Code
*
If you rent your home, are pet(s) permitted by your landlord and lease?
*
Yes
No
N/A I own my home
Are you over 18 years of age?
*
No
Yes
Drivers License Number
*
Animal you are interested in adopting
Jade (Cat - 24-350)
Jamie (Cat - 24-349)
Pasley (Dog - 24-282)
Pepper (Dog - 24-281)
Phoenix (Dog - 24-283)
Prince (Dog - 24-284)
Rainie (Dog - 24-222)
Vance (Dog - 23-1804)
Zain (Dog - 24-225)
Zaza (Dog - 24-230)
Zelda (Dog - 24-229)
Zeus (Dog - 24-228)
Ziggy (Dog - 24-227)
List any other pets you're interested in meeting
Please check the main reason you plan to adopt a pet:
Companion
Family Pet
Child's Pet
Guard Dog
Companion for another pet
Other
If you answered "other" above, please explain here:
If adopting a dog - select all traits that interest you
Running Buddy
Outdoor/Active
Small Dog
Couch Potato
Well Rounded Family Dog
What behaviors would you NOT tolerate in a dog?
Are you looking for a male of female?
Male
Female
Doesn't matter
What age range(s) are you considering
Kitten
Puppy
Young
Adult
Senior
Where will your pet spend most of its time?
Indoors
Outdoors
Combination of both
If looking for a cat - please select all that apply
Lap Cat
Great Mouser
Indoor Only
Outdoor Only
Indoor/Outdoor
If adopting a cat, will it be declawed
No
Yes
Is this pet for you or someone else?
Myself
Someone else
If the pet is for someone else, please explain
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
Are your pets current on their vaccinations?
Yes
No
n/a
Have you ever turned your dog or cat into a shelter?
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
Have you ever had a pet euthanized?
No
Yes
If yes, please explain:
Are you familiar with heartworm and heartworm prevention?
No
Yes
Including yourself, how many people live in your household?
Please list the ages 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 - allergic to cats
Yes - Allergic to Dogs
Allergic to both
No
Possibly
N/A
On average, how many hours per day will your pet be left alone?
Will this pet be predominantly living inside, outside, or both?
Inside
Outside
Both
Please provide a description of this pet's living conditions.
Do you have a fully fenced yard?
No
Yes
What kind of fence?
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 let the animal out?
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 you keep the animal up-to-date on vaccinations and heartworm preventative?
No
Yes
If no, please explain:
Have you ever been convicted of abuse or neglect of a child or animal?
No
Yes
If yes, please explain:
If you drive a pick up truck, would you allow the animal to ride in the back/bed?
Yes
No
N/A
Are you willing to take responsibility for this animal for the next 10-20 years?
No
Yes
If no, please explain:
For what reason(s) would you consider returning/giving up the animal?
Will you allow us to perform home checks?
No
Yes
I have read the foregoing and hereby submit that the information provided by me is true. Any false information may result in my losing the privilege of adopting a pet from AARS. I understand that AARS has the right to deny my request to adopt an animal and that this application mut be completed and approved, by AARS, before an animal may be considered. I authorize AARS to contact veterinarian(s) to investigate statements in this application.
Yes
No