Adoption Application
By completing this application, you are stating that you understand there is a fee for adoption. This fee covers, but is not limited to, transportation to and from the fosters' home (often from hundreds of miles away), food for the animal, vaccinations, neuter/spay, training, and medical care.

The kitten/cat adoption fee typically ranges from $25.00 - $100.00.
The puppy/dog adoption fee typically ranges from $200.00 - $250.00.

We do call all veterinarians and references. Ensure your current pets are up to date on vaccines and spayed/neutered (unless a medical reason they are not) or your application cannot be completed. It's also helpful to give your references a head's up that we'll be calling as we follow through carefully on each and every application. Please contact us at tothemoonandbackrescue@yahoo.com if you have any questions.
Name *
Your answer
Email *
Your answer
Phone number *
Your answer
Can we text? *
Full address (please include city and state) *
Your answer
Do you own or rent? *
If you rent, please provide name of landord or leasing office, including phone number. This is mandatory if you rent.
Your answer
Is your yard fenced in? *
Please provide names, occupation (for the adults) and ages of all household members, including applicant. *
Your answer
Is there a particular pet you're applying for? *
Your answer
If no to the above, please describe your ideal dog: age, gender, breed, size, activity level
Your answer
Is there a breed you would/could not adopt? *
Your answer
Are all members of the household on board with adopting a pet? *
Are you willing to adopt a pet that is: *
Required
Where will the pet spend most of the day? *
Your answer
How many hours will the pet be left alone? *
Your answer
Where will the pet sleep at night? *
Your answer
Who will have primary care (both physically and financially) of the pet?
Your answer
Do you agree to provide health care by a licensed veterinarian? *
Do you agree to keep this pet as an indoor pet only? *
Do you agree to contact To The Moon and Back Rescue if, at any point, you can no longer keep the pet? *
Are you willing to let a representative of To The Moon and Back Rescue complete a home visit? *
What other pets do you have? (if none, write none) *
Your answer
Are all pets UTD on vaccines and altered? If unaltered, please provide reason. *
Have you ever surrendered a pet? *
Your answer
If yes to the above, please explain. If no, write n/a. *
Your answer
Have you ever euthanized a pet? If so, why? *
Your answer
How do you discipline your pets? *
Your answer
Veterinarian's Name and phone number *
Your answer
Please provide a character references with phone number. These people cannot be related to you. Three total required. *
Your answer
Please provide a character references with phone number. These people cannot be related to you. *
Your answer
Please provide a character references with phone number. These people cannot be related to you. *
Your answer
Please list any additional comments here. This is where you can tell us more about you, your lifestyle (active, sedentary), what kind of pet you're looking for, etc.
Your answer
By typing your name below, you agree that all of the information you have given is true and complete. This animal will reside in your home as a pet. You will provide quality food, fresh water, indoor shelter, affection, annual physical examinations, and vaccinations under the supervision of a licensed veterinarian.
Your answer
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