Sierra Pacific Furbabies Adoption Application

Animal you are interested in adopting

Applicant's First Name *

Applicant's Last Name *

Street Address *

City *

State *

Apartment Number (if applicable)

Zip Code *

Phone Number *

Email Address *

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

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 *