Sierra Pacific Furbabies Adoption Application

Animal you are interested in adopting
Name of Animal interested in if not listed above
Applicant's First Name *
Applicant's Last Name *
Street Address *
City *
State *
Apartment Number (if applicable)
Zip Code *
Primary 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 *
Is this pet for you or someone else? *
Do you own other pets at the current time? *
If yes, please list their names, breeds, and ages.
Have you ever turned your dog or cat into a shelter? *
If yes, please explain?
Do you a regular vet you use? *
Veterinarian's Name If you have never owned a pet please tell us where you would go.
Veterinarian's Phone Number
Why do you want to adopt a pet? *
Do you own or rent your home? *
Please select your current residence type. *
If you answered "other" above, please explain here:
If you rent, does your landlord and lease allow pets? *
First/last name & phone number of lanlord
Does your landlord charge a pet deposit and/or a monthly pet fee?
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? *
Does anyone in your household have allergies to dogs/cats? *
Are you financially able to care for this pet? *
Will this pet be predominantly living inside, outside, or both? *
If adopting a cat do you plan on declawing? *
Are you willing to take responsibility for this animal for the next 10-20 years? *
If no, please explain:
Will you allow us to perform home checks? *
Do you have a legacy plan in place? *
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. *
Signature *
Date *