Adoption Application- Critters 4 U Rescue
Email *
Name of animal you are interested in
Name of Applicant
Name of Co-Applicant
Age of Co-Applicant
Driver's License Number and State
Street Address
Zip Code
Home Phone
Cell Phone
Email Address
Applicant's Employer and Phone Number
Position Title
Veterinarian's Name and Phone Number
Number of children in your home and their ages
Do the children live with you:
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Number of Adults Living in Your Home
Is anyone home during the day?
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Who will be responsible for caring for the animal?
Would you consider the location of your home to be
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Type of home
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Do you own or rent? (If you rent you must prove that you are allowed to have animals and whether or not there are any breed restrictions?)
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Landlord's Name (if applicable)
How would you describe the activity level in your home?
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Do you have a fenced in yard?
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If yes, what is the height of the fence?
If yes, how many gates do you have and how are they secured?
I have a:
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Why do you want to adopt an animal?
Many rescued animals have been abandoned and may have behavioral and/or emotional issues. How are you and your family prepared to deal with these issues?*
Will you animal be kept:
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How long will the animal be left alone during the day?
When your animal is home alone will they be:
During the night your animal will be:
Please list any animals PREVIOUSLY owned (other than fish, rodents, and reptiles) and describe what happened to them.
What animals currently live in your home? Please list name, age, breed, how long you have owned them, their gender.
Are all vaccines up to date for animals living in your home? We will verify with your veterinarian.
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Do you believe in spaying/neutering?
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Are all animals in your home spayed/neutered? We will verify with your veterinarian.
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An animal can depend on your for 14 years or more. Are you prepared for this commitment?
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Have you ever given up an animal before? If yes, please explain why.
What types of behaviors would cause you to return your animal?
Are you willing to crate train to help with behavior issues?
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Are you willing to attend behavior classes to help with behavior issues?
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What will you do with your animal when you go on vacation?
What will you do with your animal if you move?
Under what circumstances would you return your animal
Please give the names and phone numbers of two references such as a neighbor or friend (no family members please).
Individuals who adopt from Critters 4 U Rescue Inc. are contacted periodically for an update to help ensure the animal successfully adjusts to its new home. If you adopt your animal from Critters 4 U Rescue Inc. will you consent to occasional contact to ensure your animal is doing well in your home?
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I certify that I have never been convicted of animal cruelty, abandonment, neglect, or abuse.
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If at any time an adopter cannot keep an animal, it must be returned to Critters 4 U Rescue Inc.By checking I Agree, I acknowledge that I have read this questionnaire completely, and comprehend the Adoption Application fully. I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application of the adoption contract can result in forfeiture of the Critters 4 U Rescue Inc. animal adopted by me
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A copy of your responses will be emailed to the address you provided.
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