Adoption Application Applicant #1 * First Name Last Name Applicant #2 First Name Last Name Applicant #1 Email * Applicant #2 Email Applicant #1 Phone * (###) ### #### Applicant #2 Phone (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Type of Residence * House Condo/Townhouse Apartment Do you rent or own your residence? * Rent Own If you're currently renting, please provide your landlord's contact information. Name, Email, Phone Number Employer Information * Employer Name, Address, Phone Number Name of animal you're interested in * An at home visit is required after initial meet and greet. Do you agree to allow us in your home? * Yes No Are you over 18? * Yes No Do all adults in your home know you are applying to adopt an animal? * Yes No Please list all members of your household. For any children under 18 years, please list their ages as well. * If none, please say N/A. Please list any pets and type of pets that are currently part of your household. * If none, please say N/A. Are they up to date on vaccinations, spayed/neutered? Yes No Were they adopted from a rescue or shelter? Yes No If yes, please provide the rescue/shelter name. Please list any past pets and their breeds you've had within the past 10 years. * If none, please say N/A. Were they adopted from a rescue or shelter? Yes No If yes, please provide the rescue/shelter name. Veterinarian Info Clinic Name, Dr.'s Name, Address, Phone Number. Does anyone in your household have allergies, asthma, autoimmune disorders, or upper respiratory issues? * If yes, please describe. If no, please say N/A. Who will be the primary caregiver for the animal? Who will care for the pet when the primary caregiver is away for business or vacation? * Approximately how much time (hours per week) will the primary caregiver have available to spend with the pet? * How many hours a day will the pet be left alone? * None 1-4 4-8 8+ In what parts of your house will your pet spend its daytime and evening hours? Where will it sleep? * Under what circumstance(s) would you not want to keep the pet? * Select all that apply. Divorce/Separation New Job New pet not getting along with other pets New pet not getting along with household members Moving Lack of Time New Baby New Relationship Allergies Serious Illness Noise Complaints Housebreaking Issues Aggression Destructive Behavior Anxiety Excessive Barking None Are you aware that pets require a great deal of activity, socialization, enrichment, care and maintenance, and that it can be costly to keep a pet fed properly, provide appropriate veterinary care, and housing? * Yes No Are you aware that your pet may develop habits that include destruction of furniture, clothing, drapery, fear of strangers or certain household members and that these behaviors require time and a commitment to modify? * Yes No Please list TWO personal references. * List their relationship to you and their contact information. Completing the application does not guarantee that you will be matched with one of our animals. We are under no obligation to disclose our reason(s) for our decision. Your initials and date verify that you understand our policy and have answered this application truthfully. * Please Initial. Date * MM DD YYYY Thank you! A member of our team will review your application and be in touch to discuss the next steps in the adoption process should your application be approved.