Pet Adoption Application

Thank you for your interest in our pets. We would appreciate your answers to following questions so that we can best select the right pet for you. All information is treated as confidential. Submission of this application does not guarantee that you will receive a pet. Applications without addresses and phone numbers will be discarded.

NAME:                                                                                                 Date:                                      

ADDRESS:                                                                                                                                                                  

CITY:                                                                                       STATE: ______ ZIP:                                                  

Phone: HOME:                                                WORK:                                               CELL:                                    

Email:                                                                                                                                                                         

Where did you hear about our organization?                                                                                                            

Do you own or rent?                                       If renting:   House   Duplex   Apartment   Condo   Farm   Mobile Home  

Does your lease permit pets?      Yes      No

Landlord:                                                                                  Phone:                                                                       

Age and sex of children in the same home:                                                                                                              

Does the child/children have experience with pets?                                                                                                 

I am interested in:       Dog                 Puppy              Cat                  Kitten               Other                                      

Specific pet(s) you are inquiring about (name):                                                                                                        

Preferred age: Youngest                     Oldest                                                 Sex:     Male     Female            Either

Why are you interested in adopting a pet?                                                                                                                

What do you like about them?                                                                                                                                   

What do you NOT want in the pet?                                                                                                               

Where will your pet live?         Inside Only                 Outside Only               Mostly Inside               Mostly Outside

Approximately how many hours per day will the pet be alone?                                                                                 

What will you do with the pet when you go on vacation?                                                                                          

If you have to move, what would you do with the pet?                                                                                              

How would you handle deviant behavior? (Example: cat scratching furniture, dog chewing shoes, etc):

Current or past vet name or clinic:                                                                             Phone:                                    

Are you aware that owning a pet is a life long, and sometimes costly commitment?        Yes                  No

Please add any information, facts or comments, which might aid in picking the right pet for you:                          

Cats Only:

What are your views on declawing?                                                                                                                          

Do you plan on having the cat/kitten declawed?                                                                                                       

Dogs Only:

Do you have a fenced in Yard?                        If so, type of fence?                            Height?                                   

Have you ever taken a puppy through puppy class?                                      (Yes)               (No)

Have you ever taken a dog through obedience class?                                   (Yes)               (No)

If obedience classes are recommended for the dog, will you attend?           (Yes)               (No)

* I agree to have this pet spayed/neutered (if not already done so), and to return this pet to the Coalition if I need to give it up.

Signature                                                                                                                                 Date