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Adoption Info
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Adopt Me
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Name of Animal you wish to adopt
*
Name
*
First
Last
Phone Number
*
Email
Physical Living Address (Where the dog will reside)
*
How long have you lived at this address?
*
Do you...
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Own
Rent
If renting, what is your landlord's name and phone number?
Have you received permission from your landlord to have a pet)s)?
Yes
No
Where will the pet go if you move?
*
Employer Name
*
Employer Phone and Address
*
How long have you been at your current place of employment?
*
Please list names and ages of all family members residing in your household:
*
Is anyone in your home allergic to animals or have asthma?
*
Yes
No
Did your entire family agree on the adoption of this pet?
*
Yes
No
Has anyone in your house ever been convicted of animal cruelty, neglect or abandonment?
*
Yes
No
Have you ever had to give up a pet?
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Yes
No
If yes, please explain:
Do you have a fenced in yard?
*
Yes
No
Please check fencing prior to bringing pet home
How many hours a day will your pet be home alone?
*
Where will your pet be kept during this time?
*
Where will your pet sleep at night?
*
What food will you feed your pet?
*
Dog Experience
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1st Time Owner
Have had one or two
Knowledgeable/Experienced
What type(s) of pets do you own or have you owned in the last 10 years? Please include Type/Breed, Kept Where, Age, Sex, Fixed, Still Own
*
If you do not still own all of the above pets, what happened to them
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If all pets are NOT spayed or neutered, why?
How much money do you anticipate spending yearly to vaccinate, license, feed and provide medical care for your pet?
*
Veterinarian: Name, Address and phone number
*
Can we contact your Veterinarian?
*
Yes
No
Please contact your Vet and give permission for them to speak to us
Do you realize your pet may live 15 years or more?
*
Yes
No
Do you realize that your pet may not be houstrained?
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Yes
No
Are you willing to housetrain your new pet?
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Yes
No
Will you allow us to visit your home before the adoption process is complete?
*
Yes
No
Please provide TWO personal references
*
I certify that the above information is true and understand that false information may result in nullifying this adoption. I authorize an investigation of all statements on this application
*
Yes
Please Print Name and Date
*
This will act as your signature
Submit