EmailMe Form - Animal Adoption Application

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Home Phone *

### - ### - ####

Cell Phone

### - ### - ####

Work Phone

### - ### - ####

fax

### - ### - ####

Email

What Species of animal are you interested in adopting? Name(s) if applicable: *

Why? *

Your Occupation: *

Spouse/SIG's occupation:

Are there any children in the household? *

Yes

No

If yes please list names, gender & age:

If no are you planning to have children? *

Yes

No

Does anyone in the household object to adopting this species of animal? *

Yes

No

Type of Home: *

house

condo

apartment

Other

Do you own or rent? *

own

rent

Do you have landlord's, homeowner's or condo association's permission to keep this species of animal? *

yes

no

N/A

Does anyone in the household have asthma or allergies? *

yes

no

Are there any other pets in the home? *

yes

no

If yes, please list quantity, species and ages:

Are you planning to purchase or adopt any other pets?

yes

no

If yes, what species?

Does anyone in your household have previous experience with the animal species you are interested in adopting? *

yes

no

If yes, who and how many years?

Have you owned pets in the past that you no longer have? *

yes

no

If yes, please list what species, how long you had them and why they no longer are with you: (if they died, please list cause)

Do you currently have a vet? *

yes

no

If yes, vet's name, location & phone #:

What would you do if your animal came to you with or developed bad habits? *

Do you feel you are financially able to provide for the animal you wish to adopt, in terms of veterinarian costs, food, housing, toys, etc? *

yes

no

How much would you budget annually to care for this animal? *

Are you aware that animals can carry diseases which could be transmitted to humans? *

yes

no

Are you prepared to put in the effort to keep the cage clean, the food and water fresh and to work with the animal consistently and patiently on a daily basis to build a relationship of trust and companionship? *

yes

no

Why are you interested in adopting rather than purchasing this species of animal? *

Under what circumstances would you not be able to keep the animal? *

Have you done any prior research on the care an behavior of this species of animal? *

yes

no

If no are you willing to do the research prior to adoption? *

yes

no

Do you have a suitable cage/housing available for your new pet? *

yes

no

How much time will the primary caregiver have available to spend with the animal on a daily basis? *

How many hours per weekday will the animal spend alone (without human companionship) in your home? *

Weekends? *

How much daily "out of cage" time do you expect to be able to provide for the animal for exercise and interaction? *

Who would care for your animal if you went on vacation or fell ill? *

Would you object to an inspection of your home, before and after the adoption by Majical Miniatures? *

yes

no

Is there anything else you would like to say regarding your desire or qualifications to adopt this species of animal?

How did you hear about us?

Date Time

MM / DD / YYYY

Signature: *

Donation fee *

Name

First Last