Adoption Application
Animal you are interested in adopting
*
Archie (Dog - 24154)
Billy-Bob-Joe (Dog - 24252)
Bruce (Dog - 24246)
Burt (Dog - 24231)
Cisco (Dog - 24061)
Copper (Dog - 24064)
Cowboy (Dog - 24195)
Delilah (Dog - 24251)
Emmett (Dog - 24155)
Hawk (Dog - 24232)
Ivan (Dog - 24250)
Jasper (Dog - 24097)
June (Dog - 24253)
Kronos (Dog - 24111)
Lew Lew (Dog - 24049)
Liam (Dog - 24248)
Max (Dog - 24194)
Muttly (Dog - 24105)
Nellie (Dog - 24212)
Rex (Dog - 24169)
Sammy (Dog - 24217)
Sara (Dog - 24099)
Seth (Dog - 24229)
Tica (Dog - 24222)
Tracy (Dog - 24067)
Velvette (Dog - 24249)
Zion (Dog - 24069)
Zorn (Dog - 24066)
Applicant's First Name
Applicant's Last Name
Street Address
City
State
Apartment Number (if applicable)
Zip Code
Phone Number
Please use the following format 248-555-1212
Email Address
Please enter correctly as this is the main way we will contact you
Alternate Phone Number
Date of Birth
Drivers License Number
How did you find out about us?
Petfinder
Internet Search
Family/Friend
Staff/Volunteer
Facebook/Twitter
Other
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
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
Are you familiar with heartworm and heartworm prevention?
No
Yes
If you have pets, will they adjust to a new pet in the house?
Yes
No
Unsure
N/A
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:
Please describe in detail the pet you are looking for.
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
Dorm
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
If you rent, does your landlord and lease allow pets?
Yes
No
Unsure
N/A
Including yourself, how many people live in your household?
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
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 completely fenced-in yard? If so, what kind of fence?
Wood
Chain Link
Electric
Plastic
Iron
Other
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?
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:
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:
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
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:
For what reason(s) would you consider returning/giving up the animal?
What would you do with your animal if you had to move?
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:
Will you allow us to perform home checks?
No
Yes
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
