STARS Adoption Form
Email address *
First and Last Name *
Your answer
Age *
Your answer
Name of Animal *
Your answer
Street Address *
Your answer
Street Address 2
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Email *
Your answer
Confirm Email *
Your answer
Phone Number *
Your answer
Occupation *
Your answer
Work Schedule *
Your answer
List Others Who Will Be Residing In The Household On A Regular Basis *
Your answer
Do You Have Children That Regularly Come To Visit Your Home? Include Name, Age, Circumstances. *
Your answer
On A Typical Day, How Many Hours Are You Away From Home? *
Your answer
Where Will The Pet Be During This Time Period? *
Your answer
This pet is for: *
You live in a *
Do you *
If you rent, have you checked with your landlord for approval? *
Do you have a fenced-in yard? *
If yes, is it fenced on all sides? *
If yes, what type of fence? *
Do you have a dog kennel or dog house in the backyard? *
If yes, when will your dog use it?
Your answer
Will you use a chain, tie out, or cable runner to restrain your dog outside? *
If yes, under when?
Your answer
Do you live near/on a lake, canal, pond, retention pond? If so, please describe. *
Your answer
Do you have a pool? Is it enclosed? Is your dog allowed in it? Will you provide exit training? *
Your answer
Where will the pet be kept during the day? *
Your answer
Where will the pet be kept when you travel and are away from home for extended periods of time? *
Your answer
How will you exercise the pet? *
Your answer
Will the pet be walked? *
How often? *
Your answer
On leash or off leash? *
Your answer
Will they be allowed to run free off leash? Describe the circumstances if yes. *
Your answer
Who will be primarily responsible for the care of this animal? *
Your answer
Will this be your first pet? *
If no, what were your previous pets?
Your answer
Was, or is, your animal on heartworm prevention? *
What heartworm prevention do you use? *
Your answer
Have you ever sold, given away, put a pet in a county shelter, or euthanized a pet? If so, please describe the circumstances. *
Your answer
Will your animal have run of the house, or be blocked-off in parts of the house? Please explain. *
Your answer
Will your animal use a crate or be on a tieout outside, or live in the yard? Please explain. *
Your answer
WIll your animal be allowed on the furniture or bed? *
If you have had a pet die due to age, illness, or accident, please explain. *
Your answer
Do your neighbors have pets? *
What breed and sex? Are they neutered or spayed? *
Your answer
Are the neighbors' pets allowed to run off leash? Please explain. *
Your answer
Give name, address, phone number of current veterinarian along with current or previous pets' names. *
Your answer
If you haven't had a pet in the past, why are you considering getting one now? *
Your answer
Are you agreeable to an onsite inspection of the residence where the pet will be living? *
Applicant First Name *
Your answer
Applicant Last Name *
Your answer
Today's Date *
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Co-Applicant's First Name
Your answer
Co-Applicant's Last Name
Your answer
Today's Date
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