Adoption Application

Name Of Animal:

Applicant 1

Name: Phone: DOB:
Retired/Disabled Employer: Phone
Address: City: State:
How Long at this Job: Years: Months:

Applicant 2

Name: Phone: DOB:
Retired/Disabled Employer: Phone
Address: City: State:
How Long at this Job: Years: Months:

Applicants Address

Address: City: State: Rent/Own:
How Long have you been at Current Address
Years: Months:

Pet Questions:

Have you ever surrendered or given away a pet
Have you ever adopted from a shelter/Rescue:
Are you able to financially care for this pet:
What do you think is the yearly cost to care for this pet:

Household Information

For dogs do you have fenced yard? Type:
If no fence how will you contain the dog?
Number of Household: Adults: Children: Childrens Ages:

Other Information

What will happen to the animal if you move:
Will the new animal be kept indoor or outdoor?
How will you give the new animal time to adjust to the home or any other pets in the home?
List all your current pets and any you had within the past 5 years:
Breed? Age? Altered? Indoor/Outdoor? Howlong owned?

Name of Your Vet Clinic: Phone:
If adopting a dog are you willing to take the dog to training classes if required?

Please Check each statement that you agree

You are 18 years of age or older.
Proof of home ownership or landlord verification is required.
All current pets are up to date on vaccinations and altered.
All information provided is accurate.
If I adopt an animal that is too young to be altered prior to adoption I will provide proof of intent to do so before the animal can go home. (I will have the animal altered by the age of 6 months.)
I understand that adopting a new pet is a long term commitment and I will provide this new pet with the proper care he/she needs.

By Submiting this application I acknowledge that I have read and understand the conditions of this application.