Adoption Application

Name of Animal Interested In *

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Home Phone Number *

Cell Phone Number *

Email Address *

Age *

Licence # and State Issued *

Occupation *

Names, ages and occupations of others living in household, along with their relation to you. Please list each individual, including roommates and children. *

What are your thoughts about Declawing? *

Does everyone in the household want to adopt an animal? If no, please explain in detail. *

What type of animal are you looking for? (Check all that apply) *

If this pet is a gift, for whom? *

Please tell us a bit about yourself and why you are looking to adopt. Please be specific; the more information we have, the better we are able to determine the best match. *

Do you own or rent your home? *

Own

Rent

Other (be specific) Other (be specific)

What type of residence do you live in? *

If renting, do you have landlord's permission to have a pet? *

N/A (I am not a renter)

Yes

No

Yes, with certain conditions (please explain) Yes, with certain conditions (please explain)

Does your residence have fencing? If so, please describe type and height of fencing. *

If you do not have a fenced yard, please explain how you will handle your pet's bathroom and exercise needs. *

Does your residence have a dog/cat door? *

Yes

No

Please list ALL pets currently living with you (if more space is needed, please include in final question for additional information)

	Pet 1	Pet 2	Pet 3	Pet 4	Pet 5
Name	Pet 1	Pet 2	Pet 3	Pet 4	Pet 5
Species and Breed	Pet 1	Pet 2	Pet 3	Pet 4	Pet 5
Age	Pet 1	Pet 2	Pet 3	Pet 4	Pet 5
Spayed/Neutered?	Pet 1	Pet 2	Pet 3	Pet 4	Pet 5
Inside, Outside or Both?	Pet 1	Pet 2	Pet 3	Pet 4	Pet 5
How Long Owned?	Pet 1	Pet 2	Pet 3	Pet 4	Pet 5
How Did You Obtain the Pet?	Pet 1	Pet 2	Pet 3	Pet 4	Pet 5

Please list any additional pets you have had in the past, including species, breed and history. Please be specific as to why you no longer have the pet and include ALL relevant details. (Did the pet die? If so, how? Was it given away or sold? Taken to the pound? Please include all pets you have had as an adult (i.e., not childhood family pets) *

How many hours will your pet be left alone during the day? How will you handle your pet's needs if you need to be gone for an extended period of time? *

Where will your pet be kept when alone? *

How will you exercise your pet? *

Does anyone in your family have allergies to dander/hair? If yes, how do you plan to handle? *

Who is your veterinarian/clinic? *

Veterinarian Contact Info: Clinic Name, City/State, Telephone *

How much money will you spend if your pet becomes injured or ill? *

How many hours per day do you have to exercise/play with your pet? *

What will you do with your pet if you have to move? *

If you were to become unable to care for your pet due to illness, injury or death, who would take guardianship/responsibility for the pet? *Including notifying Adopting Agent per Adoption Agreement terms *

Have you ever had to give up a pet for ANY reason? Please explain in detail. *

Pets can dig, chew, bark, jump up on people and even bite. How do you plan to deal with these or any other potential behavioral problems? *

What reasons would cause you to return the pet to us? *

Is there anything else you would like to tell us about yourself? Please also use this section if additional space was needed for any above questions. *