*      Thank you for taking the time to submit the following adoption application. Our foster parents use this information to make the best match between the preferences of potential adopters as well as the individual needs and personality traits of the pet/s of interest.

*      Your information will be kept confidential and will not be shared with any outside party. 

*      You will be contacted within 48 hours of submitting your application.  This application does not obligate you in any way.  If your application matches with available pet/s, you will be invited to meet the animal/s  in “purrson” prior to making any adoption commitment. 

*      Please answer all questions.

Date:

Your name:   Phone:   (ex:123-456-7890)

E-mail address (required):                                                                        

Major cross-streets for your home address:

Name of cat/s or dog/s you are interested in:

Tell us about the cat/dog you are looking to adopt: (check as many as apply)

  1. Age:  Kitten/Puppy (under 16 weeks old) Adolescent (5-11 months)  Adult 
    No preference

  2. Coat: Long hair/fluffy   Short hair   No preference

  3. Gender: Male   Female   No preference

  4. Playfulness:  Extremely Moderately Intermittently  Observer

  5. Temperament: Extrovert/Confident  Friendly/Selective Quiet/serene 
    No preference

  6. Affection Preference: Lap Cat/Dog Cuddly  Sit next to me  Independent 
    Likes to be held

  7. How would you describe the activity level in your home environment?
    (check as many as apply)
    Very active/lots of coming/going/visitors Busy with children &/or other pets
    Routine/Quiet  Noisy Sedate/extremely quiet/not home much

Tell us about yourself and your family environment:

  1. Your age: under 18 18-30 31-50 51-65 65+

  2. As an adult, have you cared for a pet before?  Yes   No     
    If so, for how long?

  1. Do children live in the home? (or visit regularly?)     Yes  No
    If so, how many?  What are their ages?  under 5yrs  6-12 yrs 12+
  1. Why are you interested in adopting an animal? (Please check as many as apply)

            Family pet   Playmate for child/children   Gift for friend/family member

            Personal companion   Companion for other animal/s    Mouser/pest control

  1. Is every member of your household in agreement about acquiring a companion animal?
     Yes No   Not sure

  2. Is anyone living in your house allergic to pets?     Yes     No   Not sure

  3. Who will be the primary caregiver for this animal (taking to vet, feeding, walking, cleaning, etc.)

           Me (adult)  Child/children    Other adult housemate/spouse/partner  

Tell us about the pets you currently have at home:

  1. How many other animals live in your home?

Dogs Ages  
Are they all spayed/neutered?Yes No  Are they all current on annual vaccinations?Yes No

How long have they been with your family?
  

Cats Ages
Are they all spayed/neutered?Yes No Are they all current on annual vaccinations?Yes No

How long have they been with your family?
Are your cats declawed?Yes No
 

 Birds Ages

 How long have they been with your family?

 

 Other pets Ages

 How long have they been with your family?

  1. Who is your veterinarian?
    Clinic:  

    1. Have you lost a pet in the last ten years?Yes No   
      If so, when?

                               Ran away  Injured/killed    Illness  Old age/deceased
                              Other (please explain)

  1. Have you relinquished an animal in the last 10 years? Yes No

If so, what were the circumstances?  Moving   Divorce  New baby 
Allergies  Kids not taking care of pet Behavior problem
Too many pets  Financial costs   Lack of time to care for pet
HOA/rental property/ insurance restriction 
Other:

  1. How long will the cat/dog be left alone during most days of the week?  
     
    0-5 hrs   6-10 hrs  10+ hrs
  2. Would this cat/dog live…  Outdoors     Indoors   Both indoor/outdoors          

  1. What is your plan for pets should you have to relocate (move?)
                                                                           

  1. Do you plan to de-claw the cat?  Yes   No     Not Sure
    Comments regarding declawing:

  1. Do you currently have (or plan to get) a “doggie/kitty door?”   Yes    No
  2. Do you have fenced back yard? Yes  No  Not applicable           
  3. Food and pet supplies can cost well over $500 each year.  Are you prepared to meet
    the expense of annual vaccinations, periodic veterinary examinations, medications,
    and veterinary care as needed?   Yes  No  Not sure

  1. Are you committed to caring for the animal throughout its entire lifetime
    (which could easily span 15+ years)? Yes   No

  1. Do you    Rent/Lease your home    Own home

                                                           * Renters: Are you fully aware of all pet policies and prepared to pay
                                all required pet deposits?Yes   No

 (A copy of your lease agreement & pet policies may be requested.)

* Owner/Renters: Are you fully informed of any pet restrictions imposed by
  homeowners insurance or homeowners association pertaining to breed, size,
  and/or number of pets allowed? Yes   No

  1. How did you hear about us? (check as many as apply)

                   Adopt-A-Pet website  I have adopted from you before 
                             Newspaper   Petfinder.com website  Veterinarian office                             
                             Referred by friend or previous adopter                               
                             Other 

    All of the information I/we provided in this application is true and correct. I understand that submission of an application does not guarantee I will be selected to adopt this animal.

Please click the Submit button only once! It will take a few seconds for our system to process this form.