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Lookng to Adopt?
Please fill out the correct application below:
Dog Adoption
Requested Information
Date:
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January 2021
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First Name:
Last Name:
Adopter's Age:
Spouse's First Name (if applicable):
Spouse's Last Name (if applicable):
Spouse's Age (if applicable):
Address (Street, City, Region, Postal/Zip, Country):
Phone, Home:
Phone, Cell:
Email:
If you do not currently own a pet, keep in mind that you are applying to adopt one and will need to secure a vet before placement.<br>Vet's Name:
Vet's Address (Street, City, Region, Postal/Zip, Country):
Vet's Phone:
Personal Reference #1
First Name:
Last Name:
Phone #:
Personal Reference #2
First Name:
Last Name:
Phone #:
Requested Information Section 2
Your Employer:
Ever house trained a dog successfully
Choose an option
Yes
No
Are you applying for a particular dog? If so, which one?
If not, what kind of dog do you want and why? Be as specific as possible.
Number of Adults in Home?
Number of Children in Home?
Childrens Ages:
How long have you lived at your current address?
If less than 5 years, please list previous addresses
Do you own or rent?
Choose an option
Own
Rent
If rent, please provide landlord's name, address, phone:
In what type of home do you live?
Choose an option
Home
Condo
Apartment
Single Family
Townhouse
Rowhouse
Mobile
What type of environment?
Choose an option
Suburban
City
Other
Does your home have a basement?
Choose an option
Yes
No
Does your home have a yard?
Choose an option
Yes
No
To feed, vaccinate, license & provide medical care for this animal, what do you anticipate spending yearly? Consider the following estimated costs: One vet office visit: $35-$50 Annual shots: $20-$25 each X 3 shots/year = $ Plus food, grooming, bed, medications, neuter/spay,sick dog visits, license, etc.<br>Can you afford the care?
Choose an option
Absolutely
I think so
Maybe
No
If you adopt a dog and discovered a costly medical problem ($1000+), that is correctable, what would you do?
Are you willing and prepared to deal with potential medial problems and/or special needs, should they arrive, in the future?
Choose an option
Absolutely
I think so
Maybe
No
Which member(s) of the household will feed and care for this animal?
Plan for crate use - check all applicable answers
Have you considered the full ramifications of caring for a dog for its entire life- including illness and old age?
Choose an option
Yes
No
Check all traits you are looking for in a dog:
Do you prefer a male or female dog?
Choose an option
Yes
No
When you are away from your home for a few hours, where will the dog stay while you are gone?
How many hours a day will this animal be alone?
When you go away for a few days, who will care for this animal?
Where in the house will your dog be kept most of the time?
Where will your dog sleep at night?
If necessary, will you take your dog to an obedience class?
Choose an option
Yes
No
Have you previously owned a dog?
Choose an option
Yes
No
If so, what kind(s)... Breed - Sec - Age - Sprayed/Neutered - Present Location:
What discipline will you use?
Are you familiar with the "pack" mentality of dogs?
Choose an option
Yes
No
What would your reaction be if you came home to pee/poop in the house?
Do you have:
Choose an option
Carpet
Hardwood
Tile
Linoleum
Area Rugs
What age rande are you looking for?
What weight preference are you looking for?
Would you consider a dog with special needs?
Choose an option
Yes
No
Would you consider adopting a bonded pair?
Choose an option
Yes
No
Have you ever given up a dog, or taken a pet of yours to a shelter?
Choose an option
Yes
No
Do you have other pets? If so, list: breed, age, sex, size of each:
Are all other pets current vaccinations?
Choose an option
Yes
No
Are your animals on heartworm preventative?
Choose an option
Yes
No
How long would you allow an adopted dog to adjust to you, your home and your current pets (if you have any) and what would you do after that period of time, if the dog has still not adjusted?
List any humane societies, organizations, breed or training clubs you are associated with.
What do you know about rescues?
Why do you want to adopt a dog from a rescue?
We attempt to provide you with an honest evaluation of the temperament of any dog we have to place. Do you realize that often times the complete history of the animal may not be known, and you may encounter some behavioral issues? Are you willing to work with us on correcting those problems?
Choose an option
Yes
No
How much research have you done about the breed?
Please list any comments or questions you have.
I certify that the information provided on this form is true and correct. I am also financially and physically able to care for the animal. I understand that proper food and veterinarian care may be costly, and I am able to meet these requirements. Submitting this application denotes information provided is true and correct. If, upon a home inspection, we find that information contained in this application is false, we retain the right to turn down your request or remove the animal from your premises without a refund of monies paid. If you decide that you cannot take care of the dog/want the dog, money will not be refunded. Submitting this application denotes acceptance of terms.
SIGNATURE OF POTENTIAL ADOPTER
DATE
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January 2021
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Su
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Tu
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SIGNATURE OF RESCUE REPRESENTATIVE
DATE
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January 2021
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Su
Mo
Tu
We
Th
Fr
Sa
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31
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Submit
Cat Adoption
Requested Information
Date:
‹
January 2021
›
Su
Mo
Tu
We
Th
Fr
Sa
27
28
29
30
31
1
2
3
4
5
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7
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21
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23
24
25
26
27
28
29
30
31
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2
3
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5
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First Name:
Last Name:
Adopter's Age:
Spouse's First Name (if applicable):
Spouse's Last Name (if applicable):
Spouse's Age (if applicable):
Address (Street, City, Region, Postal/Zip, Country):
Phone, Home:
Phone, Cell:
Email:
If you do not currently own a pet, keep in mind that you are applying to adopt one and will need to secure a vet before placement.<br>Vet's Name:
Vet's Address (Street, City, Region, Postal/Zip, Country):
Vet's Phone:
Personal Referance #1
First Name:
Last Name:
Phone #:
Personal Reference #2
First Name:
Last Name:
Phone #:
Requested Information: Section 2
Your Employer:
Are you applying for a particular cat? If so, which one?
Number of adults in home?
Number of Children in home?
Childrens ages:
How long have you lived at your current address?
Do you own or rent?
Choose an option
Own
Rent
If rent, please provide landlord's name, address and phone:
In what type of home do you live?
Choose an option
Single Family
Townhouse
Rowhouse
Mobile Home
Condo
Apartment
What type of enviornment?
Choose an option
Suburban
City
Other
To feed, vaccinate, license and provide medical care for this animal, what do you anticipate spending yearly? Consider the following estimated costs: One vet office visit: $35-$50, Annual shots: $20-$25 each x3 shots a year. Plus food, grooming, bed, medications, sick visits, license, etc. Can you afford the care?
Choose an option
Absolutely
I Think So
Maybe
No
If you adopt a cat and discovered a costly medical problem ($1000+), that is correctable, what would you do?
Are you willing and prepared to deal with potential medical problems and/or special needs, should they arrive in the future?
Choose an option
Absolutely
I think so
Maybe
No
Which member(s) of the household will feed and care for this animal?
Have you considered the full ramifications of caring for a cat for its entire life- including illness and old age?
Choose an option
Yes
No
When you are away from home for a few hours, where will the cat stay while you are gone?
How many hours a day will this animal be alone?
When you go away for a few days, who will care for this animal?
Have you previously owned a cat?
Choose an option
Yes
No
If so, what kind(s), Breed - Sex - Age - Spayed / Neutered - Present location:
What discipline will you use?
What would your reaction be if you came home to pee/poop in the house?
What age range are you looking for?
What weight preference are you looking for?
Have you ever given up a dog/cat, or taken a pet of yours to a shelter?
Choose an option
Yes
No
Do you have other pets? If so, list breed, age, sex, size of each:
Are all other pets current on vaccinations?
Choose an option
Yes
No
Are your animals on heartworm preventative?
Choose an option
Yes
No
How long would you allow an adopted cat to adjust to you, your home and your current pets (if you have any) and what would you do after that period of time, if the cat has still not adjusted?
What do you know about rescues?
Why do you want to adopt a cat from a rescue?
We attempt to provide you with an honest evaluation of the temperament of any cat we have to place. Do you realize that often times the complete history of the animal may not be known, and you may encounter some behavioral issues? Are you willing to work with us on correcting those problems?
Choose an option
Yes
No
How much research have you done about the breed?
Please list any comments or questions you have:
Requested Information: Section 3
I certify that the information provided on this form is true and correct. I am also financially and physically able to care for the animal. I understand that proper food and veterinarian care may be costly, and I am able to meet these requirements. Submitting this application denotes information provided is true and correct. If, upon a home inspection, we find that information contained in this application is false, we retain the right to turn down your request or remove the animal from your premises without a refund of monies paid. If you decide that you cannot take care of the cat/want the cat, money will not be refunded. Submitting this application denotes acceptance of terms.
SIGNATURE OF POTENTIAL ADOPTER:
DATE:
‹
January 2021
›
Su
Mo
Tu
We
Th
Fr
Sa
27
28
29
30
31
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
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2
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SIGNATURE OF RESCUE REPRESENTATIVE:
DATE:
Submit