Animal Adoption Application

Please fill out the following information clearly and honestly..


Date:(*)

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What animal are you interested in?(*)

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Full Name:(*)

Please type your full name.

Home Phone:(*)

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Cell Phone:

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E-mail:(*)

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Address:(*)

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City, State, Zip:(*)

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Employer:(*)

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Number of adults in the household including yourself:(*)

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Number of children in the household including yourself:(*)

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Is everyone in the household in agreement about adopting a new pet?(*)

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Does anyone in your household have any known allergies to animals?(*)

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How long have you been at the above address?(*)

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Are you planning to move in the near future?(*)

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Please check all that apply:(*)

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If you rent you need a lease stating that animals are allowed before being considered.


Landlord Name:

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Landlord Phone:

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Are animals permitted?

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Do you have a lease stating animals are permitted?(*)

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For the Dogs:


Do you have a fenced yard?(*)

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Fence Type:

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Fence Height:

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How will you exercise the dog? Where? How often?

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Have you had animals in the PAST? If yes please list breeds.

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Please list animals you CURRENTLY have including breed, sex, age, neutered/spayed, and if they are current on vaccinations.

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Your CURRENT or PAST Vet Information.
If you have never owned a pet before and therefore did not have a vet, please disregard this section.
Please notify them that we will be calling to do a vet check.


Vet Name:

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Vet Phone:

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Vet Address:

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Vet City/State/Zip:

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Name the vet records are under?

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A dog/cat can live up to 20 years. Are you prepared and willing to give the medical treatment it needs for it's life span?(*)

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Last Vet visit?

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Do you agree to have this animal spayed/neutered if it is not already?(*)

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Are you prepared to bring your pet for its yearly exam and vaccinations?(*)

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Where will this animal you adopt spend most of its time? (Check all that apply)

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How long will the animal you adopt be left alone during the day?(*)

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Are you willing and able to attend training classes if needed?(*)

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Do you understand that bringing an animal home you must be patient and allow time for the animal to adjust to its new house/routine? (This may include house breaking accidents, chewing, barking, whining or hiding)(*)

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Have you ever relinquished or given up an animal? If yes please explain:(*)

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How did you hear about us?(*)

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