EmailMe Form - Adoption form


Name *
Date *
Driver’s License # and State Issued *
Address: *
Do you own or rent your home? *
If Rent, what is your landlord’s name and phone number *
Home phone: *
Work phone *
Cell phone *
Email *
How many adults in your household *
How many children: *
Ages of Children *
list any animals currently in household. Name, type, age *
list any pets you have had in the past 5 years. Name, type *
Are your pets currently altered (spay/neutered) *
Who will be the primary caretaker for the animal *
Veterinarian name and phone number (for reference check) *
Where will the animal be kept during the day *
Is your yard fenced in? *
For feline adoptions. do you plan to declaw? *
For dog adoptions, do you plan to dock ears or tail? *
Are you able to accept financial responsibility for this pet *
your pet will need continued care for life *	yes i accept this commitment no, i do not accept this commitment
Upon Adoption, all care of pet is your responsibility *	yes, i understand No, i will not accept responsibility
are you willing to obtain training for your new pet if needed? *	Yes No
if your new pet is too young for alter, you must provide proof *	yes, I will alter and provide proof No, i am not willing to alter the pet
Which of our adoptable pets are you interested in *