Adoption Application

First Name *

Last Name *

Email Address *

Address *

City *

State *

Zip *

Phone 1

Where did you hear about EARPS, Inc? *

Household and Family Information

Your Age - Please note, we cannot accept applications from anyone under 18 *

Do you rent or own your home? *

If you rent, what is the name and phone number of your landlord.

List the names and ages of each member of the household *

Does anyone in the home smoke? *

Who will be the primary caregiver of this pet? *

Who is going to be spending the most time with the new pet? *

In complete sentences tell us why you want to adopt this/these animals. *

Does anyone in the household have allegies to any animals or hay/grass? *

Adoptable Animal's Information

Give DETAILED answers to the questions listed below. If your answers are not detailed enough, it may cause us to deny your application. If you do not know the answer to a question, please let us know if you would be willing to learn these items and how you would learn it. Please do not copy and paste pet care information from websites, this can also cause us to deny your application.

What species are you wanting to adopt? *

While applications are reviewed for the species in general, if you are interested in a specific animal, what is its name?

In complete sentences, tell us how much and what kind of experience you have with the type of pet you want to adopt. *

In complete sentences tell us how you plan to house this new pet. Be specific. *

Describe in detail what you are planning on feeding this pet including amounts and brands if applicable. *

What is the name and phone number of the veterinary clinic you are going to use to provide vet care for this pet? *

For every dog, cat, and ferret you currently own, tell us when it was last vaccinated. *

List all of your current pets, the last time they were seen by a veterinarian, and why. *

Have you ever had to surrender or rehome a pet? *

Under what circumstances would you consider surrendering or returning an animal? *

Have you or anyone in your household ever bred animals before (on purpose OR by accident? *

Is there anything else you would like us to know?

STOP! READ THIS BEFORE SUBMITTING:

I certify that the above is true and correct. I understand that providing false or incomplete information may result in an automatic rejection of my application.

Initial: *