Pet Adoption Application

Thank-you for your interest in adopting from our rescue!  Please fill out our application so we can learn how to help you find the perfect pet!

Name:

Address:

Home Phone:

Work Phone:

Cell Phone:

Email Address:

Name of animal you are interested in:

Why do you want to adopt this animal?

Do you have children or grandchildren living with you?

Please list other residents of the household:

Please list pets currently in your household:

Name                              Species                 Current on Vaccinations?

Are ALL household members in complete agreement to adopting and caring for a new animal?

About Your Home:

What kind of home do you live in?

Do you rent or own?

How long have you lived at your current address?

If you rent, do you have permission from your landlord for a pet?

Please provide your landlords name and phone number.

May we have your permission to contact your landlord?

Do you have a fenced yard?

Your Experience With Animals:

If your previous pets died, please give the age and cause of death:

Have you had to give up a pet?

If yes, what were the circumstances?

If you have/had pets, may we contact your veterinarian?

Veterinarian’s name and phone number:

Please provide us with another reference:

Caring For Your Animal:

Who will be the primary caregiver of your animal?

How long are you gone each day?

Where will your animal stay while you are gone during the day?

Where will the animal sleep at night?

How will you exercise your dog?