Adoption Application

Name of Pet
Applicant Name
Name of Co-Applicant
Address
City and State
Zip
Home Phone
Cell Phone
work phone
Email Address
Best Number and Day/Time to Contact
Applicant Occupations and Work Schedules
Costs
Household
Pets in Household
Are all pets spayed or neutered?
If No, please indicate status of Pet.
Heartworm preventative
Name of Preventative
Pet Contacts
Visitors
Do you own or rent your home?
Yard
Do you have a dog door?



Will this be your first Pet?



Pet History
Have you ever bred a pet?



Have you ever sold a pet?



Have you ever given a pet away?



Surrender
Do all family members want a pet?





Reasons
Good Caregiver
Lifestyle
Active Pet
Activity
Shedding
Allergies
Family Activity
Is anyone home during the day?





Please describe fence (height,condition)
Alone Time
Daytime
When you travel with your pet, will they





Restraints
Will the pet be primarily kept



Provisions
Life Changes
food
Move
Crating
Nighttime
Please check all that apply to pet:













Cat
Will the cat be declawed?



Will the cat be allowed outside?



Laws
Home visit
Indicate best Time/Day for a Home visit
May we contact your Veterinarian?



Contact Information
How would you discipline your pet?
Ever had a pet with behavior issues?
Check all viable reasons to give pet up

















How many years will you keep your pet?
Who is primarily responsible for pet?
How would you try to find a lost pet?
Destructive behavior
SYMPTOMS
Time
Donation
Terms and Conditions
NOTICE-Must Read and Acknowledge
Attestation
Thank you
Comments/Suggestions