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Adoption Application
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Adopter Name
*
Your answer
Complete Mailing Address
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Your answer
Phone Number
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Your answer
Email Address
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Your answer
What is the name of the animal that we have that you are interested in adopting?
Your answer
Due to breed restrictions, do you rent or own your home?
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RENT
OWN HOME
How long have you lived at your residence?
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Your answer
How many people live in your household?
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Your answer
How many animals live in your household?
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Your answer
Name of animals:
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Your answer
If you own your animals, who is your vet?
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Your answer
If renting, do you have landlord's permission to adopt a dog? What is your landlords contact info?
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Your answer
Does your property have a yard?
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Yes
No
Does your property have a fence?
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Yes
No
How many hours of the day would the dog or cat be alone?
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Your answer
Why do you want a dog/cat?
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Your answer
Are you prepared for veterinary expenses such as emergency medical problems, yearly vaccinations, heartworm and flea/tick preventatives?
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Yes
No
Name the animals you have had in the past 10 years that you no longer have. List reasons why you don't have them.
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Your answer
Have you ever contacted a rescue to pick up a stray animal that has been on your property?
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Yes
No
Have you ever sold, gave away, or surrendered an animal to a shelter?
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Yes
No
Where would the dog/cat stay when alone?
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Your answer
Where would the dog/cat sleep at night?
*
Your answer
Thank you for wanting to rescue!!
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