Adoption Application SAS

- Applicants must be at least 21 years of age.
- Please have I.D. or utility bill ready to show proof of current address at adoption.
- Unanswered questions may be considered an incomplete application.

Name of Animal you are interested in adopting *
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Applicant's First Name *
Applicant's Last Name *
List all adults in household by name *
Street Address *
Apartment, Lot or Unit # (if applicable)
City *
State *
Zip Code *
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Email Address Please enter correctly as this is the main way we will contact you
Phone Number * Please use the following format XXX-XXX-XXXX
Alternate Phone Number
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Date of Birth *
Drivers License Number
Driver's License State
How did you learn about us?
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Do you own or rent your home? *
Check all that apply *
Name of Parent you live with
Parent Phone Number
Landlord or Leasing Agency Name If you rent, this is a mandatory field
Landlord/Agency Phone Number If you Rent, this is a mandatory field
Is there anyone under 18 years of age in this household? *	Yes No
Please list the ages of the children who live in your household
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Have you owned this type of pet before?
Do you own any pets at the current time? *
Pet's Name
Gender
Type of Pet
Closest Breed
Pet's Age
Pet Spayed or Neutered
Is (was) pet primarily Inside or Outside?
How long did you own this pet?
Reason and year no longer with you (if pet is not under your care now)
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2nd Pet's Name
Gender
Type of Pet
Closest Breed
Age
Spay or Neutered
Is (was) pet primarily Inside or Outside?
How long have you owned this pet?
Reason and year no longer with you (if pet is not under your care now)
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3rd Pet's Name
Gender
Type of Pet
Closest Breed
Age
Spay or Neutered?
Is (was) pet primarily Inside or Outside?
How long have you owned this pet?
Reason and year no longer with you (if pet is not under your care now)
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4th Pet's Name
Gender
Type of Pet
Closest Breed
Age of Pet
Spay or Neutered?
Primarily Inside or Outside?
How long have you owned this pet?
Reason and year no longer with you (if pet is not under your care now)
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Use this space to list additional animals you currently have. Please list all information about each one as was asked in the sections above.
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Veterinarian's Name and Phone Number for animals listed above (if no veterinarian is listed, we will assume you do not have a regular veterinarian)
Previous Veterinarian and Phone Number for animals listed above
First and Last name of person on the Vet Clinic records
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How long will you give this pet to adjust before considering rehoming? *
Please check the reason you plan to adopt this pet. (Choose all that apply) *
If you answered "other" above, please explain here:
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Is everyone in your household aware that you are planning to adopt a pet? *
Does anyone in your household have allergies to dogs/cats? *
Have you ever been convicted of abuse or neglect of a child or animal? *
Please Explain:
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Vet bills can average $200 or more yearly. Are you prepared for this expense? *	Yes No
Will this pet be predominantly living inside, outside, or both? *
Are you familiar with humane procedures for housetraining?
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What will you do with this animal when you go on vacation or must leave the country? *
For what reason(s) would you consider rehoming or giving up this animal?
What would you do with your animal if you had to move?
If there are any answers you wish to explain, please use this area
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1. Applicants for animal adoption must be at least 21 years of age. 2. Any questions not answered, please explain why it isn't answered in the notes field at the end of the questions above. 3. Applicant must agree to abide by all the city animal ordinances for the city in which they reside. 4. All dogs and cats three months and older are required to be spayed or neutered before the animal goes home with an adopter. For animals under the age of three months, adopter will pre-pay spay/neuter fee and will be given a voucher to have the surgery done when the animal is old enough. Spay/neuter must be done by the date on the voucher. 5. Applicant with young children will be evaluated based on the compatibility between the child and animal, which will be evaluated by Animal Shelter staff prior to adoption. 6. If for any reason the adoption is not successful or the owner cannot keep this pet, it will be the responsibility of the owner to find a new home for this pet. In the case the adoption was made with a voucher for spay/neuter, the spay/neuter MUST be complete prior to rehoming via agreement on the voucher. Springdale Animal Services may review a situation on a case-by-case basis where is illness or severe incident within 3 days after adoption. 7. Animal are placed as companion animals, not as guard dogs and typically not as mousers. We prefer strongly that your new pet will be kept inside your house and made a part of the family. 8. A Meet-and-Greet is required for shelter dogs that can come out of the kennel with dogs in the household. Although, this is not a guarantee of how the dog will behave in a home environment, it can help to identify a dislike between animals. 9. If an applicant owns other animals, they must be current vaccinations, including rabies vaccination which must be administered by a licensed veterinarian. 10. Animal are generally not adoption to applicants having a history of ordinance violations, losing, giving away, selling animals or having animals injured or killed by moving vehicles. 11. Verifiable and secure photo identification is required at the time of application and/or adoption. 12. An animal will not be adopted to applicants providing false information on the adoption application.
I have read the foregoing and acknowledge the policies therein. I further 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. I am also aware that the Springdale Animal Shelter cannot guarantee the health and temperament of any animal at this facility.
Signature: *