Adoption Application Form

Thank you for your interest in our rescue program and for considering adopting one of our animals! We created the following questionnaire to assist in finding the appropriate animal for you. We ask for your understanding in that we are by no means questioning your integrity. It is our sole intent to ensure your satisfaction, and our animal's welfare. This questionnaire is the first step in our Adoption Process. Please review the entire Adoption Process so you will be aware of the various steps involved in adopting a rescue animal. We appreciate your time and will contact you shortly.

Please fill out the form below to complete your adoption application.

Contact Information

First Name

Last Name

Address

City

State

Zip Code

Home Phone

Cell Phone

Your Veterinarian

Office Number

What kind of animal are you interested in?

Animal Name

Breed

Size when grown (lbs)

Do you prefer to: Adopt
Foster

Sex: Male
Female

Preference in Age: Puppy
Young
Adult
Senior

Hair Length: Short
Medium
Long

What are you looking for in a pet?

Companion for existing pet
Companion for yourself
Playmate for children
Other:

Information on other pets:

Do you currently have another pet? Yes
No

Breed:

Age:

Is your pet spayed or neutered? Yes
No

If not, why?

Former Pets

When was the last time you owned a pet?

Breed:

Age:

Was your pet spayed or neutered? Yes
No

If not, why?

About Your Home

Do You: Own
Rent

Type of dwelling: House
Condo
Apartment

Landlord's name:

Contact number:

Time your pet will be home alone daily: Less than 8 hours
More than 8 hours

Will your pet live inside? Yes
No

Will exercise take place daily Yes
No

Where will your pet get sleep?

General Information

Have you ever adopted a pet from us? Yes
No

Have you ever surrendered a pet to us? Yes
No

Have you ever surrendered an animal? Yes
No

If you have answered yes to any of these questions, please explain:

Agreement: If you adopt a puppy or kitten you are required to have him/her fixed at or before 6 months of age.

You agree to obey your local laws regarding owning an animal. EX: Leash Laws

You WILL return the animal to us if you are no longer able to keep it. You must NOT sell or give away the animal.

You are responsible for providing: Food, Water, Shelter, Exercise, Medical Care, and Humane Treatment at all times for your pet.