Information About Your Home
Which of the following best describes your current residence?
Family Home Condo
Do you own or rent?
Does your residence have a: (check all that apply)
Yard Dog Run
Tie Out Dog
If fenced please specify type and height of fence: Type of Fencing
If you do not have a fence, please explain how you will address the dog's exercise and bathroom needs, etc.
Information About Your Household Members
Please list the people that currently live in your household or
(Please list relationship to you & their age. We don't
need the children's names.)
Does anyone in the household have any known allergies to animals?
If yes, please explain.
The noise/activity level in your home is usually:
Maximum number of hours your newly adopted pet will be left alone
Where will the pet be kept while you are at work or not at home?
Where will the pet be kept primarily?
Who will be the primary care giver for the newly adopted animal?
In the event that this person is no longer able to care for
this pet, what will happen to it?
The Animal You Want To Adopt
Type of companion animal you are seeking:
- Please specify below
If for some reason the animal you are interested in adopting is
unavailable or if you have
no specific animal in mind, please tell us what kind of pet you want to adopt...
your preferences with regard to breed, sex, age, color etc: Describe your ideal
Why are you interested in adopting? Please check all that apply.
Companion for Self
Companion for Family
Protection For Child
Replace Previous Pet
Companion for Other Pet
Other - Please specify
What activities do you plan to share with your newly adopted pet?
Would you describe yourself as a pet owner who is:
Please list bad habits that your newly adopted pet might exhibit
that you could not tolerate?
Is this your first pet as an adult?
If no, please list pets you have or have had in the past years and the duration they were with you.
What happened to these animals?
How do you plan to introduce the new pet to the household?
Please provide the following information so we can contact your
address please, including city and zip code.
Please include area code.
Date, pet name and reason for most recent vet visit.
We reserve the right to check your status with your vet and to
inspect all homes and yards prior to approving any adoption
Is this okay? Yes
Are you prepared for the expenses that are incurred annually for
routine yearly veterinary visits and vaccinations?
Although not often, animals sometimes will have a medical issue
that was not evident during it's stay at Angels in Waiting of New York, Are
you willing to assume the pet's medical expenses for emergencies or previously un-diagnosed medical
Your Experience With Animals
Have you ever had any complaints about your pets?
If yes, please explain.
Are your current pets friendly with other animals?
A new pet will take time to adjust to you, the new environment,
other pets and new routines. What do you consider to be a reasonable
What will you do if your newly adopted pet develops behavioral problems,
such as separation anxiety (chewing, barking, etc) or has difficulty with
Would you consider providing humane obedience training and/or behavioral
Are you familiar with crate training? Yes
Would you like information about it? Yes
you willing to provide grooming as necessary?
you provide identification for this pet?
you aware of local pet ordinances and NYS licensing laws?
you willing to allow us to visit your home as part of the pre-adoption
Please List 2 Personal References (unrelated to you)
Have you ever had to give up an animal?
If so, please provide the circumstances.
Any other comments you'd like to add for consideration of your
application to adopt? Or questions for Angels In Waiting Rescue?
How did you hear about us?
Would you consider volunteering for our organization
At This Time
If yes, which of the following areas interest you?
Foster Care Personal
interviewing of adoption candidates Fundraising
us at an Adoption Event
I certify that the information I have provided on this form is true, correct, and accurate. I understand and agree that falsification of any of the above information is grounds to disqualify my adoption application and nullify all
adoptions and/or adoption agreement . I understand that there is no obligation to
adopt an animal to me, now or in the future. I understand that clicking yes below
is considered an electronically-generated signature and is valid as a means of legal signature for the purpose of this adoption application.
Clicking the Submit Button will return you to our website.
The application process may take a number of days, due to the
need for confirmation of the information provided..
of an application does not guarantee placement of a dog.