Crossroads Pets Adoption Application
Online application for Crossroads Clients
Email address *
Your Name *
Are you over 21 years of age? *
Which pet are you interested in?
Phone Number *
Home address *
Do you live in: *
If you are renting, can you provide documentation stating you can house pets? *
Have you had pets in the past or currently have another pet? *
Please tell us about your past and present pet experiences?
If you currently have a pet, please list your veterinarians name & phone number:
How many hours might this pet be left alone each day? *
Are you willing/able to provide and afford regular medical care as well as annual vaccination & monthly preventative medications? *
How will you meet the pets mental/social/physical needs? *
Required
Have you ever needed to rehome or give up a pet in the past? *
What behaviors may be unacceptable to you that may lead you to need to rehome a pet? *
Please list names and approximate ages of family members and/or frequent visitors to your home. *
Do any family members have pet allergies (fur, dander, saliva, etc) that you are aware of? *
Please list names of two (non-family member) references with phone numbers: *
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Crossroads Campus.