Pet Adoption Application Complete this form to apply to adopt an animal. Step 1 of 5 20% Applicant InformationName(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneEmail(Required) Pet-related InformationWhat type of pet would you like to adopt?(Required) Dog Puppy Dog – No age preference Cat Kitten Cat – No age preference Other Name of pet you're interested in adopting Reason for adoption Family Pet Companion for yourself Companion for other pet Gift for someone Child(ren)’s pet Watch-Dog Hunting Dog Other If Gift or Other please explainDescribe any specific breed, characteristics or traits you're looking for Are there any behaviors you will not tolerate from a pet? If Yes, please explain(Required) How do you plan on training your pet?(Required) Household InformationOther than normal walks and exercise, will the pet be expected to spend a significant portion of its day or night outside of your home? If yes, please explain(Required) Will the pet be indoor only, indoor-outdoor, or outdoor only?(Required) Indoor ONLY Outdoor ONLY Indoor-Outdoor Will adopted pet live in any other address other than the one shown on this application? If yes, please explain(Required) Do you currently have any other pets in the home? If yes, please describe (Name, Breed and Age)(Required) Type of pets previously owned What happened to previous pets? In what type of housing do you reside?(Required) Apartment Condo Single-family home Multi-family home Mobile home Other Do you rent or own?(Required) Rent Own Other If you rent, are you able to provide a copy of your lease agreement and landlord reference? Yes No Do you have a fenced in yard?(Required) Yes No Please describe your household makeup, including number of adults, seniors, and children. Childrens' ages required.(Required)Are any household members allergic to pets? If yes, please explain how this will be addressed(Required) Pet Care InformationPlease provide veterinary reference information (Name, Address, Phone Number) Please provide a personal non-family reference (Name, address, phone number)(Required) Are you planning on surgically altering your pet? (e.g. ear cropping, tail docking, debarking, etc.)(Required) Do you plan on declawing your cat?(Required) Yes No Maybe Most animals have an unknown medical background, are you prepared to take your pet for a complete veterinary exam at the time of adoption if medically necessary?(Required) Yes No Do you plan on providing ongoing regular veterinary care for your new pet?(Required) Yes No Acknowledgement and CertificationI certify that I have answered all questions on this form truthfully and honestly to the best of my knowledge and ability. If this application is found to be false or misleading, my application will automatically be denied.(Required) Yes SignatureCAPTCHA