Adoption Form

Date of Application *
Date of Application
APPLICANT INFORMATION
Name *
Name
Address *
Address
Phone *
Phone
19 years or older? *
Have you ever had an application for adoption declined by an animal group/animal control or rescue facility? *
Have you ever surrendered an animal to the SPCA or other animal rescue facility ? *
Do you or anyone in your household have any legal restrictions prohibiting you from owning animals? *
Have you or anyone in your household ever been reported to the SPCA? *
Have you or anyone in your household ever had an animal seized by an animal rescue facility *
HOUSING DETAILS
Ownership *
If you rent, has your landlord given you permission to keep a pet?
Landlord Name
Landlord Name
Landlord Phone
Landlord Phone
Where will the animal be primarily housed? *
Where will the animal stay when you are not home?
Do you have a yard?
Is your yard adequately fenced to provide protection for your pet from predators?
Are there any children in the household?
What problems would make you return a pet? *
I am committed to working with this animal to correct any of these and most other problems by:
Describe your home\'s activity level: *
Do you feel that an animal should be spayed or neutered?
Do you understand that changing a pet\'s environment may cause it to have accidents? *
Have you owned animals before?
Are your currently owned animals up to date on vaccinations?
Current Veterinarian Name
Current Veterinarian Name
Current Veterinarian Phone
Current Veterinarian Phone
Are you willing/able to provide adequate food, shelter and medical care, including yearly exams/vaccines, for an adopted animal? *
Personal Reference 1 Name *
Personal Reference 1 Name
Personal Reference 1 Phone *
Personal Reference 1 Phone
Personal Reference 2 Name *
Personal Reference 2 Name
Personal Reference 2 Phone *
Personal Reference 2 Phone
Are you familiar with your local animal control laws?
Do you understand that adoption fees can be anywhere from “by donation” to $900 depending on the individual animal? *
If you adopt an animal from us, do you consent to possible home visits before and/or after adoption? *