Pets Without Parents Adoption Application
* Please answer each required question. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED! When finished, click the "SUBMIT" button at the bottom of the form.

* Please note that submitting an online application for a particular pet does not necessarily mean that pet will be placed on hold for you. A hold is issued on a "first come, first served" basis, and you will be assigned in the order received.

* In order for a pet to have the best chance of going home as soon as possible, please come into the shelter to meet the pet you are applying for to be sure it is the right fit for you. We cannot place long term holds on a pet.

* Once your application is approved and the pet has been spayed/neutered, you must complete the adoption by the next business day or your hold will be removed. Please understand that the sooner a pet is adopted and goes home, the sooner a cage frees up to save the life of another companion animal in need.
Certify Age
PLEASE NOTE: You must be at least 18 years of age to complete and submit this application. You may not complete this application for anyone other than yourself.
I certify that I am at least 18 years old AND that I am completing this application for myself. *
Pet Your Are Interested In
Pet's Name *
Breed *
Type *
Gender *
Age *
About The Applicant
First Name *
Last Name *
Email *
Primary Phone *
000-000-0000
Secondary Phone
000-000-0000
Address *
City *
State *
Zip *
County *
Employed? *
Employer
Occupation
Work Phone
Student? *
References
(Only one may be a relative)
Full Name (Ref 1) *
Phone (Ref 1) *
Relationship (Ref 1) *
Full Name (Ref 2) *
Phone (Ref 2) *
Relationship (Ref 2) *
Housing Detail
Type of Housing *
Required
Do you Rent or Own? *
Landlord's Full Name
Landlord's Phone
Number of adults in the home *
Number of children in the home and ages *
Has anyone in the home been convicted or charged of a crime related to violence? *
Experience with Pets Without Parents
Have you ever filled out an adoption application with Pets Without Parents? *
If "Yes," when did you fill one out?
Have you ever adopted from Pets Without Parents? *
If "Yes," when did you adopt?
Who did you adopt?
How did you hear about Pets Without Parents?: *
Current Pets in Home
Name (Pet 1)
Breed (Pet 1)
Age (Pet 1)
Type (Pet 1)
Clear selection
Spayed or Neutered? (Pet 1)
Clear selection
Vaccinations Current? (Pet 1)
Clear selection
How long have you owned this pet? (Pet 1)
Name (Pet 2)
Breed (Pet 2)
Age (Pet 2)
Type (Pet 2)
Clear selection
Spayed or Neutered? (Pet 2)
Clear selection
Vaccinations Current? (Pet 2)
Clear selection
How long have you owned this pet? (Pet 2)
Name (Pet 3)
Breed (Pet 3)
Age (Pet 3)
Type (Pet 3)
Clear selection
Spayed or Neutered? (Pet 3)
Clear selection
Vaccinations Current? (Pet 3)
Clear selection
How long have you owned this pet? (Pet 3)
Name (Pet 4)
Breed (Pet 4)
Age (Pet 4)
Type (Pet 4)
Clear selection
Spayed or Neutered? (Pet 4)
Clear selection
How long have you owned this pet? (Pet 4)
Vaccinations Current? (Pet 4)
Clear selection
Additional Pets in Home
If you have more than four pets, please list the name, breed, age, type, spay/neuter status, vaccination status and time you have owned each pet.
Where do these pets stay during the day?
Where do these pets stay at night?
Pets You Have Owned in the Last Five Years
(Not including current pets in home)
Name (Prev 1)
Type (Prev 1)
Clear selection
When and why did this relationship end? (Prev 1)
Name (Prev 2)
Type (Prev 2)
Clear selection
When and why did this relationship end? (Prev 2)
Name (Prev 3)
Type (Prev 3)
Clear selection
When and why did this relationship end? (Prev 3)
Additional Pets You Have Previously Owned
If you have owned more than three pets, please list the name, type, and reason why relationship ended for each pet.
Have you ever given up on a pet? *
Under what circumstances?
Veterinary Information
Current or Previous Veterinarian
Veterinarian Phone
Additional Veterinary Information
If you've used a previous vet, or your pet records are under a different name than yours (spouse, parent, etc), please provide that information in the field below.
Care of Your New Pet
Why do you want a pet? (Select all that apply) *
Required
Do you intend to breed this pet? *
Do you have a fenced yard? *
Do you own a crate? *
Where will your pet stay during the day? *
How long will your new pet be alone during the day (# of hours)? *
Where will your new pet sleep at night? *
Per year, how much do you expect veterinary costs to be? *
Can you/will you afford an average of $500 in vet expenses should this pet become ill? *
Do you anticipate any major changes in the next year (moving, new baby, etc.)? *
If "Yes," please provide details.
Your new pet could live for another 20 years. Do you understand the responsibility involved, and are you willing to make a lifelong commitment to this pet? *
If Adopting a Dog
How will you deal with behavioral issues that may arise with your new dog?
Do you expect your new dog to have accidents in the house, even if it's housebroken?
Clear selection
If Adopting a Cat
How will you prevent your new cat from scratching furniture, etc?
Will you let your new cat outside, and under what circumstances?
Do you intend to declaw your cat?
Clear selection
Additional Comments
Additional Comments
Provide any pet details or other information that you think would help us process your application.
Affirmation
Pets Without Parents, Columbus relies on the information given above to be complete and accurate in order to act on your application in a timely manner. Any false statements, misrepresentations, inaccurate information, or failure to supply the data requested may serve as a rejection of your application. By selecting "I Agree", you are authorizing the use of any screening agencies to verify criminal history and validate the accuracy of all information recorded above, and you give Pets Without Parents, Columbus the right to call your references, landlord, and veterinarian. I also understand that this application will not be fully approved until I have come in to meet the pet and been interviewed by Pets Without Parents staff. Pets Without Parents, Columbus reserves the right to reject any application for any reason.
Agree or Disagree? *
Date *
(MM/DD/YYYY)
Submit
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