ADOPTION APPLICATION
Completion of this application does not guarantee that the adoption will be approved nor that
the pet you have chosen will be held or reserved. One of our adoption counselors will contact
    you soon to help you determine if the pet you have chosen is a good fit for you and your family.

Please enter the following contact information
First Name Last Name E-Mail
Address City State Zip
Home Phone Cell Phone Work Phone
Number of adults in your household   Ages of children in your household  
May we contact you in the future to check on the welfare of your new pet? Yes No

Residential Information
Do you live in a house apartment other   Do you own rent  
If you rent, please provide your landlord's phone number   
  Do you have a doggie door? Yes No Do you have a fence? Yes No How tall?    

Please tell us about your current and previous pets
How many dogs do you currently have? How many cats? Others?
Are your current pets vaccinated ?
 Yes No N/A
Including kennel cough vaccine (dogs)?
 Yes No N/A
Including Upper Respitory Infection(cats)?
 Yes No N/A
Are they all spayed or neutered?
 Yes No N/A
Current veterinarians name Phone #   
May we contact them to ask about your current pets ? Yes No
Have you ever had to relinquish an animal, other than a stray, to a shelter?YesNo
If so, what were the circumstances ?
Please tell us about your previous pets, or anything else you would like us to know about your current pets:

Your new pet
Name of animal applied for  Dog Cat Breed  
Applying for a certain pet does not gaurantee that this pet will be held or reserved
for you unless arrangements have already been made with an adoption counselor.
Where will your new pet be kept ?
During the day ?   If you move ?  
At night ?   When you're on vacation ?  
A new pet can take 6 months to a year to fully adjust to it's new environment. Are you willing
to provide any training necessary to resolve behavior issues that may arise?  Yes  No
Routine health care can cost up to $150.00 a year and emergencies can often be over $1,000.
Are you willing to provide this care if necessary ?Yes  No
Please list any concerns you have about your new pet, or any questions you may have for us.

Please provide one personal reference

Name      Phone   
Address  Relation 
Thank you for taking the time to complete our application.
We will review it shortly and contact you very soon.
Please click the submit button to send us the form, and return to our home page.
Completion of this application does not guarantee that the adoption will be approved nor that
the pet you have chosen will be held or reserved. One of our adoption counselors will contact
    you soon to help you determine if the pet you have chosen is a good fit for you and your family.
 
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