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STAY WILD Rescue Small Animal Adoption Application
All adoption applications will be processed as soon as possible, please be patient, animal rescue and care has to come first and we are family run.
Small animal adoption fee is $75
If you have any questions, you can text Jane at (607)592-9080, email us at staywildrescueinfo@gmail.com or message our page via Instagram or Facebook
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Email
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Your email
Date of Application
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MM
/
DD
/
YYYY
Phone Number: (preferably one you can receive texts at)
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Your answer
Your Full Name (first and last)
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Your answer
Address:
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Your answer
Full name and phone numbers of adults who own/are responsible for the mortgage, rent.
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Your answer
Please list the first and last names and ages of
all
people living in the home:
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Your answer
Employment info (where you work, job title)
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Your answer
How many days a week do you work? How many hours each day?
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Your answer
What type of home do you live in?
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Choose
I own my house
I rent a house
I rent an apartment
Which companion are you interested in adopting?
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Choose
Rabbit
Other
Who are you interested in adopting? Specify the name if possible or give as much information about the type of personality you are looking for.
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Your answer
How often are you and/ or other family members home? How long will your new companion be left home alone? Are there other pets there to keep him/her company?
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Your answer
Please list all pets in the home by species, name, and age:
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Your answer
What is the name, address, and phone number of your veterinarian?
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Your answer
Are all of your pets up to date on their vaccinations, parasite control, and medical check-ups? (we may call to confirm)
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Your answer
What parasite control do you use/ plan on using?
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Your answer
Please list the name, email, and phone number of 3 references not related to you:
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Your answer
How did you find out about Stay Wild Rescue?
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Choose
Instagram or Facebook
Google Search
A friend
If you answered a friend in the previous question, what is their name, so we can thank them?
Your answer
Additional Comments:
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