Adoption Application
Adoption Eligibility Requirements:
1. Be 18 years of age or older
2. Have identification showing your current address
3. Expressed permission of property owner
* Required
Which animal are you interested in?
*
Your answer
Name: First and Last
*
Your answer
Street Address
*
Your answer
City, State, Zipcode
*
Your answer
Phone Number(s): Add home, cell & work if applicable
*
Your answer
Email:
*
Your answer
Housing
*
Apartment
House
Mobile Home
Rent
Own
Required
If Renting: Provide Landlord Name and Phone Number
*
Your answer
Do you plan to move in the next year? If yes, please explain what you will do with the animal.
*
Your answer
How many people live in your household?
*
Your answer
Number and Ages of any children under 13:
*
Your answer
Does anyone in the home have known animal allergies? If yes, please explain.
*
Your answer
Who will be responsible for care of this animal?
*
Your answer
Have you turned an animal into a shelter before? If yes, for what reason?
*
Your answer
Are you currently employed?
*
Yes
No
Are you aware that proper veterinary care can be expensive?
*
Yes
No
Do you have a veterinarian in mind for your new pet? If so, please let us know which one.
*
Your answer
Please list the animals currently residing in your home including their species (dog, cat, rabbit, etc.), their name, M/F, Spayed/Neutered and where the animal is kept (Indoor/Outdoor/Both).
*
Your answer
In most cases, it will take up to two weeks for your pet to adjust to their new home. Are you willing to allow time for your new pet to adjust?
*
Your answer
Are you prepared for a ten to fifteen year commitment with your new pet?
*
Yes
No
If unable to keep your pet at any time, do you agree to contact the SPCA before the animal leaves your custody?
*
Yes
No
How many hours a day will your pet be left alone?
*
Your answer
Do you plan to having the pet Spayed/Neutered? If no, please explain:
*
Your answer
Cat/Kitten Section:
Answer only if adopting a Cat/Kitten: If adopting a dog write "N/A" and continue to Dog/Puppy Section.
What is the reason you are adopting this animal?
*
Your answer
How would you handle the following:
Flea Infestation:
*
Your answer
Scratching up furniture?
*
Your answer
Accidents due to litter box issues?
*
Your answer
Where will this animal be kept?
*
Your answer
Do you plan to declaw?
*
Your answer
Dog/Puppy
Answer these questions if you are adopting a dog or puppy. If not, write N/A.
What is the reason you are adopting this animal?
*
Your answer
Answer the following questions on how you would handle each situation:
Flea infestations?
*
Your answer
Chewing?
*
Your answer
Accidents due to not being house broken?
*
Your answer
What do you know about heartworm prevention and treatment?
*
Your answer
Where will this animal be kept? If outdoor, what kind of shelter and confinement will be provided?
*
Your answer
I certify that all information provided is true and grant permission to the SPCA of NENC to contact my landlord, veterinarian or local animal control to verify information. I understand that the SPCA has the right to refuse adoption for any reason.
*
Yes
No
How did you hear about us?
Your answer
Signature:
*
Your answer
Date:
*
MM
/
DD
/
YYYY
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