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Thank You for taking the time to complete an Adoption Application and Thank You for considering a rescue pet.This Non-binding Application will help Karmana Farm match Adoptable Pets with their best possible home environment based on the information we hav
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Yes
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Name (or Breed) of Dog or Animal You Wish to Adopt:
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What is the primary reason you are considering this dog/ animal?
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Guard Dog.
Child's Pet.
Companion.
Farm work/ Herding.
Obedience or Agility Training.
Watch Dog.
Livestock
Horse Companion
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Are there any additional reasons you are considering this animal for adoption now?
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Applicant's Name & Age
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Street Address (P.O. Box is not acceptable)
City, State & Zip Code:
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Home Telephone:
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Applicant's Employer
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Work Telephone:
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Cell Phone:
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Email Address:
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What best describes your current living situation:
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Own my home/townhouse/condo.
Rent home/townhouse/condo.
Rent Apartment.
Own Farm.
Rent Farm.
Own Mobile Home Park.
Rent Mobile Home Park.
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If renting, provide Landlord Name, Address and Phone Number. Renters may be required to provide written documentation of permission to own pets and the Landlord's requirements, if any, relating to pets on their premises.
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Please briefly describe your living situation if none of the above choices apply.
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How long have you lived at your current address & how long do you plan to remain in the Mid-Atlantic Area?
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What kind of fence or containment system do you plan to use?
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No fence, will walk with leash.
No fence, will train to come when called.
Chain link fence.
Board or split rail fence.
Picket Fence or Board Fence.
Portable Kennel Run.
Electronic 'Invisible' Fence.
Electric Fence.
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Please describe your fence height, construction & gates and/or your plans for management of the pet's exercise needs.
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What size is your yard? (square feet)
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Please describe plans for daily management of the pet including housing, hours expected to be left alone on workdays/weekends. How you plan to handle vacations.
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What best describes your plans for where the new pet will live and sleep.
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In the home.
In a kennel or fenced yard with a dog house.
In the garage.
In the barn.
Will be allowed to come and go as it pleases.
Tie out stake or chain with dog house.
In the home with a crate.
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Please describe where the new pet will live and sleep.
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What do you estimate the yearly cost of care for this animal to be, including such items as veterinary care, occasional boarding, feeding and supplies?
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What is the activity level in your home?
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Busy- Frequent visits by friends, children.
Busy- Frequent business meetings, parties.
Noisy- TV, stereo, tools, machinery.
Moderate- regular daily comings & goings.
Quiet- 'homebodies', few guests.
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Please list the names of all persons, including non-relatives, who are living in your home. Please provide children's ages.
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Has every adult resident of the home been informed that you are applying to adopt a rescue pet?
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Yes.
No.
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Does every adult agree to participate in the introduction meeting and be present for the REQUIRED pre-adoption home visit?
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Yes.
No.
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If you are requesting an exception to the requirement that all adults meet the pet and participate in the the pre-adoption home visit, please explain.
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Is anyone in the home pregnant?
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No one is pregnant.
Not pregnant now, but planning a family.
Not pregnant now, not planning a family.
Pregnant and looking for a family-type dog.
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Who will be responsible for the pet's feeding, exercise and daily potty breaks?
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Who will be responsible for obtaining Veterinary care?
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Who will be responsible for the training of the new pet and what methods of training are planned?
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Does anyone living in the home have allergies or asthma?
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Please tell us about ALL of the pets you have owned for the past 10-15 years. Indicate whether they are still living with you, have passed away, or have had to be surrendered for some reason. For example:
Susie, border collie, 10, still lives with us.
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Please tell us about any animals you have had to return to a shelter or another rescue, or for which you have had to find a new home. Please share the reasons. For example, the health or behavior, or a move to a new home, did not like the animal, birth of
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List the Names and Phone Numbers of ALL Veterinarians treating your pets/ livestock and indicate which animals they have treated. Please indicate if you plan to use a new Veterinarian for the new pet and provide this reference information also.
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Please tell us about any major or chronic health problems with any of your pets. How were these handled? Were any conventional or alternative treatments provided?
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Please provide the Names and Home Phone Numbers of Three personal references.
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Please include any additional information you would like to share, or ask any questions you may have about the animal or about the adoption process.
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When an Adoption Agreement is reached there is a Contract to sign and a requested minimum Adoption Donation of $150. Will you comply?
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Yes
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Thank You for taking the time to complete this Application. By submitting this Application the person completing the Application agrees that they are age 21 or over, that the Veterinary and Personal References have been notified in advance that they may be contacted by a Karmana Farm Volunteer and that the submission of an application for consideration is not a guarantee of Adoption. Karmana Farm endeavors to contact all applicants by phone or e-mail within 48 hours of receiving an Application. If you do not receive a response, please contact us by e-mail at karmana@verizon.net so that we can correct any problems. Thank you for considering a rescue pet/ animal.
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Yes
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