Name of animal interested in adopting*
Description of animal interested in adopting*
Why do you want this pet?*
Is this your first experience with this type of pet?*
Have you adopted a rescue animal before?*
How long have you been looking for a pet?*
Is this animal for you or for someone else?*
Your First Name*
Your Last Name*
Your Street Address*
Street Address Line 2
Postal / Zip Code*
Years lived at this residence*
Date of Birth*
Postal / Zip Code
Number of Work Days
What are your hours of employment?
Please list the pet(s) currently residing in your home. Please indicate the type of pet, if they are spayed/neutered, if they are current on shots, and the age for each pet.*
Please list any pet(s) you have owned in the past, other than those listed above. Please indicate the type of pet, if they were spayed/neutered, if they were outdoor or indoor, the length of time you owned the pet, and the pet's status.
Are your pets on a heart worm preventative medication?
Name of Veterinarian
Cats only: Are your cats declawed?
Dogs only: How have you disciplined your dogs in the past? What type of action was taken?
What will you do if this pet is destructive when left alone?*
Are you willing to attend obedience classes with this pet, if necessary?
Are you ready for the high energy of some animals?
Who will be responsible for housebreaking, training, feeding, and overall care for this pet?*
Approximately how many hours a day will this pet spend alone without human companionship?*
When home alone, where will this pet be kept?*
What will you do with this pet when you go on vacation?*
What will you do with this pet if you move?*
Are you aware veterinary costs for this animal can become very expensive?*
Are you prepared to accept financial responsibility for this pet?*
Is everyone in your household aware that you are planning to adopt a pet?*
How many people currently reside in your home?*
Please list those residing in your home and their ages
Do you are anyone in your household have any known allergies to animals?
Please list the types of allergies and the severity
What type of home do you reside in? i.e. apartment, condo, house*
Do you own or rent your home?*
Does your residence have a fenced in yard?
What type of fence do you have? i.e. chain-link, wooden, etc.
If you rent, does your lease allow pets?
If you rent, does your lease allow for the breed that you are adopting?
Landlord's First and Last Name
Landlord's Phone Number
Are you willing to make this adoption a PERMANENT commitment?*
Please provide any additional comments you might want to add to help determine approval
* = a required field