Adoption Application

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Adopter Name *

Complete Mailing Address *

Phone Number *

Email Address *

What is the name of the animal that we have that you are interested in adopting?

Due to breed restrictions, do you rent or own your home? *

RENT

OWN HOME

How long have you lived at your residence? *

How many people live in your household? *

How many animals live in your household? *

Name of animals: *

If you own your animals, who is your vet? *

If renting, do you have landlord's permission to adopt a dog? What is your landlords contact info? *

Does your property have a yard? *

Yes

Does your property have a fence? *

Yes

How many hours of the day would the dog or cat be alone? *

Why do you want a dor/cat? *

Are you prepared for veterinary expenses such as emergency medical problems, yearly vaccinations, heartworm and flea/tick preventatives? *

Yes

Name the animals you have had in the past 10 years that you no longer have. List reasons why you don't have them. *

Have you ever contacted a rescue to pick up a stray animal that has been on your property? *

Yes

Have you ever sold, gave away, or surrendered an animal to a shelter? *

Yes

Where would the dog/cat stay when alone? *

Where would the dog/cat sleep at night? *

Thank you for wanting to rescue!!

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