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Home
Adoptables
Adoptions
Support
Volunteer
Donate
Surrendering
Contact Us
Adoption Form
Type of animal you are applying to adopt:
*
Cat
Dog
Horse
Other
Animal name, if available?
Date of Application
*
MM
DD
YYYY
APPLICANT INFORMATION
Name
*
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Email Address
*
Subject
*
Message
*
19 years or older?
*
Yes
No
Place of employment
*
Why are you considering adopting a pet?
*
Please list any preferences (age, sex, breed, temperament, activity level, etc.)
Have you ever had an application for adoption declined by an animal group/animal control or rescue facility?
*
Yes
No
If Yes, please explain
Have you ever surrendered an animal to the SPCA or other animal rescue facility ?
*
Yes
No
If Yes, please explain
Do you or anyone in your household have any legal restrictions prohibiting you from owning animals?
*
Yes
No
Have you or anyone in your household ever been reported to the SPCA?
*
Yes
No
Have you or anyone in your household ever had an animal seized by an animal rescue facility
*
Yes
No
HOUSING DETAILS
What type of residence do you live in?
*
Shared Accomodations
Apartment/Suite
House in the City
House on acreage
Other
If Other, please specify
Ownership
*
Rent
Own
If you rent, has your landlord given you permission to keep a pet?
Yes
No
Landlord Name
First Name
Last Name
Landlord Phone
(###)
###
####
Where will the animal be primarily housed?
*
Inside
Outside
Equally inside and outside
Where will the animal stay when you are not home?
Loose inside
Crated/confined inside
Loose outside
Kennel run/fenced area outside
Kennel/daycare
Friends/family
Other
Do you have a yard?
Yes
No
Is your yard adequately fenced to provide protection for your pet from predators?
Yes
No
How many people live in the home?
Are there any children in the household?
Yes
No
If yes, ages of children
Describe the kind of situation where you might have to return your adopted pet (i.e. job loss, baby, move, divorce, etc.)
*
What problems would make you return a pet?
*
Housebreaking/Litter training
Inappropriate chewing
Medical conditions
Fearful behavior
Shedding
Aggressive behavior: biting, scratching
Scratching furniture etc
Other
If Other, please specify
I am committed to working with this animal to correct any of these and most other problems by:
Yes
No
Describe your home\'s activity level:
*
Busy/active/noisy
Moderate comings/goings
Quiet with occasional guests
Do you feel that an animal should be spayed or neutered?
Yes
No
If no, why not?
Approximately how many hours each day will this animal be left home alone?
*
Do you understand that changing a pet\'s environment may cause it to have accidents?
*
Yes
No
If you were to move, what will you do with your pet?
*
Have you owned animals before?
Yes
No
If yes, list details, species and why you no longer have that animal.
Describe any animals you currently own (type, breed, age, gender, amount of time owned.
*
Are your currently owned animals up to date on vaccinations?
Yes
No
Current Veterinarian Name
First Name
Last Name
Current Veterinarian Phone
(###)
###
####
If any of your pets are not spayed or neutered, please explain why
*
Are you willing/able to provide adequate food, shelter and medical care, including yearly exams/vaccines, for an adopted animal?
*
Yes
No
Personal Reference 1 Name
*
First Name
Last Name
Personal Reference 1 Phone
*
(###)
###
####
Personal Reference 2 Name
*
First Name
Last Name
Personal Reference 2 Phone
*
(###)
###
####
Are you familiar with your local animal control laws?
Yes
No
Do you understand that adoption fees can be anywhere from “by donation” to $900 depending on the individual animal?
*
Yes
No
If you adopt an animal from us, do you consent to possible home visits before and/or after adoption?
*
Yes
No
Thank you!
