Adoption Application
PLEASE READ AND ANSWER EVERY QUESTION THOROUGHLY

Our adoption fee is $225, cash or check, for every animal. This includes spay/neuter, vaccinations/deworming and a 15lb bag of TLC Premium Pet Food!

YOU WILL NEED TO CALL YOUR VET ASAP TO RELEASE INFO TO US.
A volunteer from Open Arms Rescue of WNY will reach out to you after the vet or personal reference is complete to set up a home visit and meet & greet!

List the name of adoptable dog OR type of dog you're interested in. *
Your answer
Full Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone
Your answer
Cell Phone *
Your answer
Email *
Your answer
Vet Name OR Personal Reference (excluding family) *
If you currently have a pet or have ever had a pet - the vet reference is REQUIRED. If you've never had a pet, please list a non-family member that has known you more than 2 years.
Your answer
Vet Phone # OR Personal Reference Phone # *
If you currently have a pet or have ever had a pet - the vet reference is REQUIRED. If you've never had a pet, please list a non-family member that has known you more than 2 years.
Your answer
How many dogs/cats do you currently have? *
List name, species, breed, sex and age of current pets.
Your answer
Are they ALL spayed/neutered?
Cats and Dogs only
Are they ALL up-to-date with vaccinations?
Rabies, Parvo Distemper, etc.
How many children live in the house? *
List their ages.
Your answer
How many adults live in the house? *
Do you own or rent your residence? *
Renters - provide your landlord's name and phone number.
Your answer
Have you ever surrendered a pet? *
How many hours would the dog be left alone per day? *
hours
Where would the dog be PRIMARILY living? *
What would you do with the dog when you're not home? *
You may check multiple.
Required
Does anyone in the house have allergies to dogs/cats? *
Is your yard fenced? If so, what kind? *
If the yard is NOT fenced, what means would you take to insure the dog does not stray?
Your answer
Do you agree to provide routine vetting, grooming and proper nutrition for your adopted pet? *
How did you hear about Open Arms Rescue of WNY? *
By submitting this application, I agree that all statements I have made are true and that I am at least 21 years of age. *
If it is found that any statements are not true, the animal can be confiscated by Open Arms Rescue of WNY at any time.
Required
Any additional information you feel is necessary for the rescue to know about you and your ability to care for a pet.
Your answer
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