Adoption Application

Animal you are interested in adopting
Applicant's First Name *
Applicant's Last Name *
Street Address *
City *
State *
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
Date of Birth *
Drivers License Number *
How did you find out about us?
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.
Are all of your pets spayed/neutered/fixed?
Are your pets current on their vaccinations?
If you have pets, will they adjust to a new pet in the house?
Please check the main reason you plan to adopt a pet:
If you answered "other" above, please explain here:
Do you own or rent your home?
If you rent, does your landlord and lease allow pets?
Do you have a completely fenced-in yard? If so, what kind of fence?
If you do not have a fenced yard, how will you let the animal out?
How will you handle housebreaking?
How will you handle destructive behavior?
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.