Sample Animal Adoption Form

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ADOPT A FRIEND

FOR LIFE!

We're very pleased that you're considering adopting a future family member from us. We're confident that we can match you with just the right animal for your lifestyle and desires. It all starts with this Adoption Application. We'll begin processing your application as soon as we receive it, and will notify you of approval (usually within one week).

Once your approved Application is on file, you're ready to find your 4-footed friend. Come into the Shelter at your earliest convenience and visit our animals; when you find the perfect pet, just let the us know, and we'll complete your adoption paperwork, collect the adoption fee, and make sure you understand the importance of committing to spaying or neutering your new family member.

Our staff can help you make an informed selection, provide you with useful information on the breed or mix you favor, help you introduce your new friend to already-resident pets, and much more -- just call or drop by and chat with one of these helpful folks.

Approved Applications are kept on file for six months. If you decide you'd like to have another pet, just come on in and start looking. If you should find the perfect companion after submitting your Application but before we've called you back with an approval, just let us know -- we'll hold the pet you want while we rush through your Application. If you'd like to discuss anything about the adoption process, please feel free to call us.

Thanks for adopting your next pet from us!

People/Animal Companion Profile

This application is designed to help us help you make the best possible choice -- the right home for each animal and the right animal for your home. Please reply to the following questions carefully and completely. PLEASE NOTE: It may take a few days to process this application. You will be notified by phone when the application has been approved and is "on file." At any time after that, you may come into the Shelter and begin to look for your new "best friend." If you should see the perfect pet before you have been notified of approval, please inform the front desk folks that you've submitted an application and that it's "in process;" this will enable us to locate the application and expedite its processing. Sorry, but INCOMPLETE APPLICATIONS CANNOT BE PROCESSED.

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I Want to Adopt a: Dog Cat Puppy Kitten Other:______________

Household Information
Your Name
Driver's License #
Street Address
City
State
ZIP
Home Phone
Work Phone
Email Address
Housing: Do you: Own
                                 Rent
                                Live w/parent (circle one)
Is this a: House
                Condo
                Apartment
                Mobile Home (circle one)
Landlord name
Landlord phone #
Length of time at this address
Others living in household (include ages of children)
Personal reference #1
Daytime phone #
(Personal Reference cannot be a relative)
Personal reference #2
Daytime phone #

Pet History
What animals do you currently own? (list below)

Animal #1:
Species:
Age:
Sex: Male Female
Altered? Yes No
Kept: In Out Both
How long have you had this animal?

Animal #2:
Species:
Age:
Sex: Male Female
Altered? Yes No
Kept: In Out Both
How long have you had this animal?

Animal #3:
Species:
Age:
Sex: Male Female
Altered? Yes No
Kept: In Out Both
How long have you had this animal?

What innoculations have your current animals had in the past year?

What animals have you owned in the past? (list below)Previous Animal #1:
Species:
Age
Sex: Male Female
Altered? Yes No
Kept: In Out Both
How long did you have this animal?

Previous Animal #2:
Species:
Age:
Sex: Male Female
Altered? Yes No
Kept: In Out Both
How long did you have this animal?

Previous Animal #3:
Species:
Age:
Sex: Male Female
Altered? Yes No
Kept: In Out Both
How long did you have this animal?

What's your experience with dogs? (Circle one)
First-time owner
Have had 1 or 2
Knowledgeable & experienced

What's your experience with cats? (Circle one)
First-time owner
Have had 1 or 2
Knowledgeable & experienced

Please rate your household activity level: (Circle one)
Grand Central Station
Couch potato
Somewhere in between

Hopes and Expectations
Please circle any of the following reasons for adopting this pet:
Family pet Child's pet Watchdog Companion
Hunting dog Guard dog for business Barn cat/mouser
Companion for other pet
Other

Do you have a certain type of dog or cat in mind? If yes, please describe below:
What personality traits are you looking for in your companion animal?
Will an adult be at home during the day? Yes No Part time
If Part time, please specify

Who will be responsible for taking care of your pet?

Where will the animal sleep at night?

What behavior problems have you experienced with pets in the past, and how did you resolve them?

Have you ever adopted a pet from us or from another Shelter?
Yes No
If yes, where is that pet now?

Would you object to an authorized representative of this shelter inspecting the animal and the premises where the animal is being kept? Yes No

If you had to move, what would you do with this animal?

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QUESTIONS IN GREEN ARE FOR DOGS & PUPPIES ONLY During the day, how long will the dog be without human companionship?

Where will you keep the dog during the day? (ie, indoors, in & out, at work, in the yard)

Ability to exercise dog: (Circle one)

Minimal exercise during the week, but lots of exercise on the weekends

Would run 5 miles a day with me

Long morning and evening walks

Three 15-minutes walks each day

It varies; some days we can walk, other days there's no time

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QUESTIONS IN RED ARE FOR CATS & KITTENS ONLY Cats are known for their long daytime naps; however, they still need exercise. How will you provide this?

Scratching is typical cat/kitten behavior. How will you deal with this?

Cats lick their fur to clean themselves; this produces CAT DANDER to which many people are ALLERGIC. Have you or anyone in your household ever experienced an allergic reaction to a cat?

Yes No Unsure

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Adoption Follow-Up

As part of our commitment to having each adoption be a success, we will be keeping in touch with you. Please indicate the best time and place to reach you. Time(s) Phone ------------------------------------------------------------------------

Please Read and "Sign"

I hereby release to the Shelter all veterinary records of any and all animals I have had or currently have.

Name of Veterinary Hospital:

Vet's Phone:

By entering my name and today's date in the designated spaces below, I certify that the information in this application is true and I understand that false information may void the application. I also understand that failure to comply with future requirements (eg, vet check, licensing) and accepted standards of animal care could result in my inability to adopt other animals from this Shelter.

Name as Signature:

Date:

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THANK YOU for taking the time to complete this Application. Please stay in contact with us regarding this application and the animal you’re interested in adopting.