Pet of Interest *

Why are you interested in this particular pet? *

What characteristics are you looking for in a pet? *

Your Name *

Your Address *

Address Line 2

City *

State *

Zip Code *

County *

Occupation *

Employer *

Daytime Phone Number *

Evening Phone Number *

Number of People in Household *

Relationship and Ages of Household Members *

Spouse's Employer

Do you live in an apartment or house? *

Is anyone home during the day? (If so, when?) *

Number and type of pets in household *

List your previous pet's name and brief overview of their time with you. *

Do you have, or have you ever had a STAAR pet? (Please include the pets name) *

Will this pet be primarily inside or outside? *

Is your yard fully fenced? *

If your yard is fenced, how high is the fence?

What will you do with the pet when you move? *

Vet Name

Vet Phone