Adoption Application

Please provide the following contact information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Directions to the actual location where the animal will live:

Which animal are you interested in adopting?

Why would you want this animal? (Check all that apply.)

Companion
Guard Dog
Gift
To Breed
Personal Protection
For Child
Other

If you chose OTHER above, please explain:

Is someone home during the day?

Yes No

During what hours?

Who will be primarily responsible for this animal?

Who will be responsible for housebreaking an untrained animal?

Residence:

Own
Rent
Live with parents

Type of home:

House
Apartment
Condominium
Townhouse

If renting, please give landlord's name and
phone number, including area code:

How many children live in your home?

Children's ages:

Does anyone in your household have allergies to animals?

Yes No

Who will care for your animal while you are away on vacation?

Do you anticipate moving soon?

Yes No

Currently have an animal?

Yes No

If you move, what will you do with your animal?

Type of animal:

Sex:

Male
Female

Current Age:

--- Puppy or kitten 1 2 3 4 5 6 7 8 9 10 Over 10 Deceased

Is/was this animal neutered or spayed?

Yes No

If you no longer have the animal, what happened to it?

Do you have a veterinarian now?

Yes No

The vet's name and phone number, including area code?

How much do you think it will cost to take care of this
animal each year? (Consider the cost of veterinary care,
vaccinations, food, grooming, licensing, etc.)

Have you adopted from us before?

Yes No

Do you have a fenced-in yard?

Yes No

Type of fence:

Chain link
Wood
Vinyl
Wire

Fence height (in feet):

Where will the animal sleep?

Where will the animal stay during the day?

How will the animal be confined when outdoors?

We require that all animals be spayed or neutered.
Do you have any questions or reservations about this?

Yes No

If YES, what are they?

Do you understand that all animals will require
a series of vaccinations and that adults need
annual vaccinations, including rabies?

Yes No