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NEPA Pet Fund & Rescue Adoption Application
Thank you for choosing to adopt one of our rescued dogs or cats and for putting time and thought into filling out our application. Our goal is to match each one of our animals with the right person or family so that you will share a long and happy life together. The information you provide will help us do just that!

Our adoption fee is anywhere between $275 - $500, depending on the animal. The adoption fee contributes to the cost of: spay/neuter, micro-chipping, vaccinations, wellness exam, boarding, transportation and pull fees, monthly heart-worm and flea/tick prevention, food, treats, toys, daily socialization and activities, along with some basic training. Occasionally a dog in our care requires additional and often expensive medical care and/or professional training.


*All fields are required: If a question does not apply to you (i.e. Landlord), please write N/A. If application is incomplete, it will not be considered.

Once you submit your application, please be patient with us. The person reviewing your application is a volunteer who works a full-time job and processes applications in their spare time, as quickly as they can and we do understand that you are excited to welcome a new best friend into your family. However, we ask that after you submit your application that you do not inquire about the application progress prior to one week of submission. Please understand that it takes valuable time away from the review process to respond to each inquiry. If you do not hear back from us within one week, then, please feel free to call or email inquiring as to the status to your application.

Email address *
Full Name *
Your answer
Phone Number *
Your answer
Street Address *
Your answer
City, State, Zip *
Your answer
Age *
Your answer
Co-Applicant Name (if applicable) *
Your answer
Co-Applicant Phone Number (if applicable) *
Your answer
Please list all members in the household (including ages) that will interact with the animal on a daily basis *
Your answer
Name of animal you are interested in *
Your answer
Preference as in age, breed, size, gender *
Your answer
Check all that Apply *
Required
How long have you lived there and do you plan on moving *
Your answer
Landlords Name (if applicable) *
Your answer
Landlords Phone Number *
Your answer
Describe your yard (size, fence, etc.) *
Your answer
Name/breed/age of current or past animals living in your home (spay/neutered, medical history, etc.) *
Your answer
Describe your work schedule and the amount of time the animal would be alone on an average day *
Your answer
Do any household members have animal allergies *
Have you ever surrendered an animal in the past *
What brand food will you be using *
Your answer
Where will the animal sleep at night *
Your answer
Describe the household lifestyle and energy level (active, laid back, etc.) *
Your answer
Who will care for the animal when you are away from home *
Your answer
Any habits you will not tolerate *
Under what circumstances would you not keep your animal *
Your answer
Please provide veterinary information (NAME and PHONE NUMBER REQUIRED) If you have been with this vet for less than two years please list any prior vets *
Your answer
Please provide three non-family member references (NAME and PHONE NUMBER REQUIRED) *
Your answer
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