Adoption Application
For the desired adoption of an animal fostered by MylesAhead
* Required
Full Name:
*
Your answer
Email Address:
*
Your answer
Date:
*
MM
/
DD
/
YYYY
Address:
*
Your answer
City:
*
Your answer
State:
*
Your answer
Zipcode:
*
Your answer
Telephone:
*
Your answer
Name of Animal Applying for:
*
Your answer
Are you interested in cat/kitten?
*
Yes
No
Are you interested in dog/puppy?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
If yes explain:
*
Your answer
Do you own your home?
*
Yes
No
If renting list landlord information:
*
Your answer
Current Household
Do you have a limit on the number of animals you are allowed to have at your residence
*
Yes
No
How many dogs/cats have you owned in the past five years?
*
Your answer
Where are they now?
*
Your answer
References
Please list two personal references, other than family members.
Full Name:
*
Your answer
Relationship:
Your answer
Occupation:
*
Your answer
Phone:
*
Your answer
Address:
*
Your answer
Full Name:
*
Your answer
Relationship:
Your answer
Occupation:
*
Your answer
Phone:
*
Your answer
Address:
*
Your answer
Current Veterinary Clinic/Doctor
Clinic:
*
Your answer
Phone:
*
Your answer
Address:
*
Your answer
Veterinarian:
*
Your answer
Are all animals in your home altered (Spayed/Neutered)?
*
Yes
No
Pet Name:
Your answer
Place Obtained:
Your answer
Breed:
Your answer
Age:
Your answer
Pet Name:
Your answer
Place Obtained:
Your answer
Breed:
Your answer
Age:
Your answer
Pet Name:
Your answer
Place Obtained:
Your answer
Breed:
Your answer
Age:
Your answer
Pet Name:
Your answer
Place Obtained:
Your answer
Breed:
Your answer
Age:
Your answer
Pet Name:
Your answer
Place Obtained:
Your answer
Breed:
Your answer
Age:
Your answer
Are all pets up to date on vaccinations?
Yes
No
Clear selection
Do you plan on getting your cat/kitten declawed?
Yes
No
Clear selection
Will you be crate training?
Yes
No
Clear selection
Do you have a fenced in yard?
Yes
No
Clear selection
Military Service
Branch:
Your answer
From:
Your answer
To:
Your answer
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge.
I also certify that Myles Ahead Animal Sanctuary and Rescue may perform personal, landlord,and veterinary checks, as well as home visits in the future, if deemed necessary.
Should I be unable to maintain this animal in my home for any reason, I understand that any animal adopted from Myles Ahead Animal Sanctuary and Rescue must be returned to the rescue by the adoptive owner rather than rehoming.
Signature:
Your answer
Date:
MM
/
DD
/
YYYY
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