Adoption Application
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What kind of animal do you want to adopt? *
What is the name of the animal you wish to adopt?
Name *
Address *
Phone Number *
Employer/Phone Number *
Drivers License Number/Expiration Date *
Email *
Do you... *
Length of time at current residence *
If you rent or lease, do you have permission from your landlord to keep a pet?
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Landlords Name/Phone Number
Please list ages of all children living in your home.
Do you currently have other animals? *
If you answered yes, how many animals are in your home?
Have ALL of your current pets been spayed/neutered?
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If you have not spayed/neutered current pets please explain why.
Who is your veterinarian? *
Veterinarian Phone Number
Please type your signature below if you consent with the following statement.

I hereby authorize any Veterinarian named above to release any information and records concerning my past or present care of animals to whomever may present this application in person, by mail, by fax , or by phone.
why do you want to adopt a pet? *
How will you confine your pet to your property? *
Where will you new pet spend most of its time? *
On average, how much time will your new pet spend alone each day? *
Describe your method of housebreaking *
Will this pet live at the address listed above? *
If not, why?
Where will the animal live?
List 2 references (not related, that you've known for at least 2 years) names, addresses and phone numbers *
Please type your signature below.
I acknowledge that all the information on this form is true and correct.
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