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It will take you about about 20-30 minutes to complete this application.  Please understand that submitting an application does not obligate you to adopt, nor does it guarantee adoption.  Adoptions are always done in the best interest of the animal.

In order to adopt, you must satisfy the following requirements:
  • You must be at least 21 years of age with proper proof of age. Current identification must show your correct address and phone number.
  • Additionally, if you rent, you must also provide your landlord's contact information or a copy of your lease.

Please note that you will need to click on the 'Save' button at the top or bottom of the page when you are done in order to actually submit the application.
 
Attach FileAttach File
 * indicates a required field

Title *


Name 2


The name of the second person that is a part of this adoption

Home Phone *


(xxx-xxx-xxxx)

Mobile/Pager


(xxx-xxx-xxxx)

Email Address *


Address *


City *


State *


Zip Code *


Length of Time at the Present Address *


Adults (Number of people in the household)


Children (Number of people in the household)

   
Please specify the age of all children in the Specify your own value field (separate by commas)

Do you rent or own? *

If you rent, please provide your Landlord's name & phone number (or a copy of your lease)


A scanned copy of your lease can be attached to this application using the Attach file icon in the ribbon above.

Employer


Names of the animal(s) you are interested in *


List the dog(s) you are interested in, i.e. Fido, Rover, etc

When were you hoping to adopt/foster *

Desired characteristics of adoptable animal *

   

Reason(s) you are interested in adopting a pet?

Check all that apply

For how long have you been considering adopting a companion animal? *


Is this your first companion animal?

Do you currently have other companion animals?

Please fill out detailed information on the next field if you answer YES to this question.

Current companion animal(s)


Please specify detailed information about ALL of your current companion animal(s) by listing information such as type of animal, age, sex, breed (or mix of breeds), weight, spayed/neutered, current on vaccinations, and where the companion animal currently resides.

Have you applied to this rescue before?

Have you applied to any other rescue organization before?


1 Name of Shelter


1 Date Applied


(mm/yyyy)

2 Name of Shelter


2 Date applied


(mm/yyyy)

How do you plan to introduce your companion animal to other animals and/or people in the household? *


Companion animal adjustment period *


Are you prepared to spend several weeks or, perhaps months, waiting for your new companion animal
to adjust to their new environment? And for you to adjust to this animal?

Who is or will be your Veterinarian? *


Please list contact info such as name, address, and phone number

How much money do you anticipate on spending on your new companion animal's annual doctor visits? *


What yearly vaccines will your companion animal receive? *


Do you have any of the following: *

   
(please specify how high your backyard fence is using Specify your own value field)

What is the longest period of time you would leave your companion animal unattended outside? *


Where will your pet be kept during the day? *


Where will your pet be kept at night? *


What is the most amount of hours the animal will be left alone? *


What brand of food will you feed your pet? *


What are your beliefs regarding spaying/neutering? *


What are your beliefs regarding obedience training? *


Who will be primarily responsible for feeding/caring for your new pet? *


What do you believe is the average life expectancy of a dog/cat? *


How did you hear about our shelter? *

   

Have you ever surrendered an animal into a shelter?


If yes, what were the circumstances?


How would you handle the animal jumping on furniture/counters/tables? *


How would you handle the animal destroying/scratching the furniture? *

How would you handle the animal chewing? *

How would you handle the animal barking? *


How would you handle the animal urinating/defecating where it is not acceptable? *

How would you handle the animal keeping you awake at night? *


How would you handle the animal shedding excessive hair? *


How would you handle the animal ruining your favorite article of clothing? *


How would you handle the animal biting/play biting? *


How would you handle allergies that a current household member may develop to your new companion animal? *


How would you handle medical expenses (emergencies and diagnosis of a medical condition) involving your companion animal? *


How would you handle moving/finding new housing involving your companion animal? *


When home alone, the dog will be (check all that apply) *

   

How will you exercise the dog (check all that apply) *

   

Reference1 - Name *


Reference1 - Phone Number *


(xxx-xxx-xxxx)

Reference2 - Name *


Reference2 - Phone Numner *


(xxx-xxx-xxxx)

E-Signature1 | Print Your Name *


E-Signature1 | Date *


(mm/dd/yyyy)

E-Signature2 | Print Your Name


E-Signature2 | Date


(mm/dd/yyyy)

Attachments