Autumn Acres Animal Rescue - Adoption App
Interested in adopting one of our dogs? Please fill out this form.
Email address *
Name of the animal you are interested in?
Your name (First and Last):
Your street address:
City, State, Zip Code:
Home Phone:
Cell phone:
Household Pet Information
Do you have any pets now?
Clear selection
If you have pets now how many and what kind(please describe them). If you don't have pets now please list pets you've had in the past.
How long have you had them?
How old are they?
Would you consider them indoors mostly or outdoors mostly?
What veterinary clinic do you use for your animals?
What name would the file be under at that clinic?
Where do your pets spend most of their time?
Where do they usually sleep?
How many children are living in your home and how old are they?
How many hours is the family away from the house?
Where will your new pet sleep?
Where will your new pet stay when no one is home?
How long have you lived at your current residence?
Note: We do NOT require fenced yards. This question just lets us know if we need to warn you about a fence jumping dog. Is your yard fenced? Please describe your yard:
Do you rent or own?
Clear selection
How long at your last residence, did you have pets at the last home, if so where are they now?
Any other information you wish to let us know? Can you list any past animals within the last 3 years? Any behaviors in a new animal you can not work with?
A copy of your responses will be emailed to the address you provided.
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