Adoption Application
Thank you for considering a shelter pet! To better serve you, please answer the following questions:
Your Name: *
(first and last, please)
Your answer
I am interested in: *
(select all that apply)
Name of animal you'd like to adopt:
(optional - choosing an animal does not guarantee that the animal will be held for you)
Your answer
Phone Number: *
(please list the number where you can most easily be reached in case of questions)
Your answer
Home Address: *
(if you have lived at your current address less than a year, please list the second most recent address as well)
Your answer
Please list all members of your household and their ages: *
Your answer
Email Address: *
Your answer
Do you currently own any pets? *
If you don't currently own a pet, have you been a pet owner in the recent past?
If you have been a pet owner in the recent past, what happened to your pet? *
How many pets live in your home? Please list their names and species. *
(if no pets, please write N/A; please list pets that are considered yours and pets considered any other member of your household)
Your answer
If you own pets, are they spayed or neutered? *
If you own pets, please tell us which veterinarian they see? *
(if you don't have pets, please write N/A; if you have no pets now, but have had pets recently, please list your regular vet for those pets)
Your answer
If you own pets, do they have current rabies vaccinations? *
Have you ever surrendered an animal to a shelter or given a pet away? *
If you have surrendered or given away an animal, please describe the circumstances: *
Your answer
Have you ever been issued a warning or citation for an animal control ordinance violation or had an animal legally removed from your care? *
If you rent, please list your landlord's phone number:
Your answer
How do you plan to contain your new pet? *
(please choose all that apply)
I certify that the above information is correct to the best of my knowledge. I understand that failure to answer honestly may result in denial of adoption. *
(please sign and date)
Your answer
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