Name of Pet you are applying for:
Type of Pet you are applying for: Cat    Dog

Section I:  Personal Information

Please complete all fields. Enter None or Not Applicable if it does not apply to you.

Name
Address
City
State, Zip
Home Phone
Email Address
Cell Phone (if any)
Work Phone (if any)
When is the best time to call?
Occupation
Hours worked away from home
Number of adults in your household (including yourself)
Name of spouse, significant other, or roommate(s) (if applicable)
Number of children in your household
Ages of child(ren)
Have all members of your household agree to the adoption of this pet?
Are any members of your household allergic to dogs or cats?

Section II: Home Information

Please complete all fields. Enter None or Not Applicable if it does not apply to you.

What type of home do you live in?
Do you own or rent?

If you rent or lease, you will need to fax or mail us a copy of your rental agreement.

How long have you lived in your current residence?
Do you have plans on moving in the near future?
Does your home have a securely fenced yard?
If yes, what type of fence?
If yes, what is the height of your fence (at the lowest point)?
Do you have a built-in pool?
If yes, is the pool fenced in?

Section III:  Current and Past Pet Information

Please complete all fields. Enter None or Not Applicable if it does not apply to you.

Please list any pets you CURRENTLY own:

Species (Dog, Cat, Bird, etc.) Breed Age Sex Spay/Neutered

Please list any pets you owned in the PAST:

Species (Dog, Cat, Bird, etc.) Breed Sex Spayed/Neutered What happened to this pet?

Section IV: Cat Adoption Applicants Only   (If you are applying for a dog, skip this section and move on to Section V)

Why are you interested in adopting a cat? (Select all that apply)
Companion to Self
Companion to Child(ren)
Companion to other pet(s)
As a Gift
For Breeding
Other: Explain
What personality type are you seeking?
If you currently own other cats, are they tested for FELV and FIV?
Will the cat be allowed outdoors?
If your home currently does not have a dog, do you have plans on getting a dog?
What would you do if the cat stopped using the litter box?
What would you do if the cat clawed your best furniture?
What would you do if the cat scratched you or a member of your family?
Have you ever declawed a cat in the past?

Section V: Dog Adoption Applicants Only (If you are applying for a cat, please skip this section and move on to Section VI)

Why are you interested in adopting a dog? (Select all that apply)
Companion to Self
Companion to Child(ren)
Companion to other pet(s)
As a Gift
For Breeding
Other: Explain
What personality type are you looking for?
Where will the dog stay when you are at work or gone?
Where will the dog stay when you are home and at night?
How long will the dog be left alone?
Do you plan on keeping your dog current on heartworm tests and heartworm preventative medicine?
How do you plan to exercise the dog?
How will you discipline and train the dog?
It is common for even a housebroken dog to have accidents in the house.  How will you deal with this to (re)train the dog?
Are you willing to take the dog to obedience classes?
Are you willing to crate train the dog?
How long do you think it will take for the new dog to adjust to it's new environment and family members?

Section VI: Veterinarian / Medical Care

ALL Applicants: Please complete all fields. Enter None or Not Applicable if it does not apply to you.

Do you currently have a veterinarian?
If Yes, please provide your vet's or vet clinic's name and phone number
Do you give us permission to call your veterinarian?
Will you provide consistent veterinary care for your cat or dog, including but not limited to vaccinations, annual examinations, dental and emergency care?
Do you have a limit on how much you would spend on veterinary care if your cat or dog became ill or injured?
If YES, what is your limit?

Section VII: Additional Information

ALL Applicants: Please complete all fields. Enter None or Not Applicable if it does not apply to you.

Have you ever relinquished a cat or dog to a shelter or rescue organization?
If YES, what were the circumstances?
What would you do with this adopted cat or dog if you were no longer able to keep him/her?
Under what circumstances to you feel warrants you returning this adopted cat or dog?
Have you ever euthanized a pet?
If YES, please explain:
 
Additional Comments, Questions, or Information that you feel would help us in considering your application:
 
By submitting this application, I certify that the above information is true and accurate to the best of my knowledge and that I understand that falsification of information can be cause for denial of my application or future forfeiture of the adopted pet. Leaving questions blank or not filling out this application completely can be cause for the application to be discarded or denied.