Pocono Pet Rescue Pre-adoption Application

Pocono Pet Rescue is a small group of people helping displaced dogs and cats find new loving homes. We want every applicant to understand the responsibilities involved in caring for a pet. It is a life time commitment and many pets live 16 to 20+ years. pets are pack animals and bond with their human family and needs to be treated as a member of the family. Are you willing to make that commitment?

If yes, please complete this application then click the [submit] button at the bottom

1. Personal Information:

  1. Name: Age:
  2. Address: City:
    State: Zip:
  3. Home Phone: Best time to call:
  4. Email:
  5. Place of Employment:
    Work Phone:
  6. Driver's License:
  7. Tell us a little bit about yourself.

2. Name and breed of pet you would like to adopt:

  1. Would you consider another pet if the one named above were unavailable?
    YesNo
  2. If yes, what type of pet would you be interested in?

3. Why do you want to adopt this pet?

4. What do you think are the most important responsibilities in owning a pet?

5. For whom are you adopting the pet?

6. Have you ever owned a pet before?Yes No

    If Yes:
  1. Please describe any pets that are currently with you (type, age, sex, altered status).
  2. Please describe any pets that are no longer with you (type, age, sex, altered status)
  3. What happened to the pets who are no longer with you?

7. Please provide the following information about the Veterinarian for your pets.

  1. Name:
  2. Address:
  3. Phone:
  4. Hours:

8. How many people reside in your household?

9. Are there any children in the household? Yes No.

10. Does anyone have allergies?Yes No.

11. Who will be responsible for feeding, housebreaking and training?

12. Do you own or rent your residence?

13. Does your residence have a fenced yard?Yes No.

14. Where will the pet stay during the day?inside outside both

15. Where will the pet stay during the night?inside outside both

16. How much time will the pet spend outside?

17. Will anyone be home during the day?Yes No

18. How many hours will the pet be left unattended?

19. When no one is home, where will the pet be kept?

20. Where will the pet sleep?

21. What do you intend to feed the pet?

22. How will you housebreak the pet? (If applicable)

23. What course of action would you take if the pet you adopted became seriously ill?

24. References:

  1. Name: Phone:
  2. Name: Phone:

By submitting this form I attest that the information that I have provided is the truth to the best of my knowledge and belief. I also understand that completing this form in no way guarantees me, nor obligates me to, adoption of the pet named above.
AgreeDisagree

Have you answered all the questions?
Incomplete applications will not be considered.

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