Email *
Phone *
Street Address *
City, State, Zip Code *
Which animal are you applying for? *
How many people, including children, live in your home? *
Do you rent or own your home? * Rent Own
What type of dwelling do you live in? *
What are the ages of everyone living in your home? *
How many pets do you currently have? *
What kinds of pets do you currently have? *
Are your pets current on vaccinations and monthly preventatives? *
What kind of pets have you had in the past and where are they now? Feel free to be detailed. *
If yes, what type of pool? Is it fenced in securely?
Please list the name, address, and phone number of your current veterinarian. Note - part of the adoption approval process is a vet reference check. *
How many hours a day will your new pet be unsupervised? (Family at work, etc.) *
How will your new pet be kept safe while you're away from the home? *
What type of dog food do you typically buy? *
On a scale of 1-10, how active would you rate your family? (1 being very active and 10 being couch potatoes) *
Are you willing to give your new pet the proper vet care they need for the life of the pet, or surrender the animal back to the rescue if the time comes when such care cannot be provided? *
How much time are you willing to give your new pet to adjust to his/her new environment? (barking, house training, etc.) *
We never adopt any animal out as “Housetrained.” Just as it takes time for you to learn your new animal's routines, it will take time for them to learn yours. We will, however, be as upfront and honest as possible as to how the pet has been doing. Are you willing to be patient and work with them as they get settled in? *
Why do you want to adopt this animal? *
Are all of the animals currently in your family spayed/neutered? If no, explain: *
Have you ever had to rehome an animal before? If yes, why? How did you rehome them? *
Are you willing, upon approval, to travel or assist in transporting your new animal home if necessary? *
Print Name *
Signature *
Date *
Print Second Adopter's Name (if applicable)
Second Adopter's Signature (if applicable)
Date