| Full Name: |
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| Address: |
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| Phone Number: |
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| Email Address: |
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| Name of animal you are interested in (Given by Sanctuary)?: |
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| Describe a day in the life of this animal if you adopt?: |
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| What is the primary reason for wanting to adopt?: |
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| Do you own any animals currently or in the past? Give name, age, and breed.: |
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| Have all your animals (past and present) been up to date on all vaccinations and given monthly Heartworm prevention?: |
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| Are your animals spayed/neutered? If not, explain.: |
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| Are your pets indoor or outdoor? If outdoor, do they have dog house or adequate shelter?: |
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| Have any of your animals shown aggression towards people or other animals?: |
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| Who is your current vet? List name, number, and location.: |
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| Do you have fenced yard/pen/invisible fence?: |
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| What is height, size, and type of fencing? Is it completely fenced?: |
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| Do you own a pool? If so, do you have steps or ladder for easy exit?: |
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| Do you live near main highway or busy road with high traffic?: |
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| Do you live in neighborhood or on land? If land – how many acres?: |
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| Have you ever surrendered a pet to a shelter OR given away? If so, explain.: |
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| If adopting a cat, have you ever had any of your cats declawed?: |
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| What are the ages of the children living in the home?: |
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| Are you aware that animals are unpredictable around children?: |
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| Do you understand that it is your responsibility to make sure children do not abuse or provoke this animal?: |
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| How many hours will your pet be left alone during the day and/or night?: |
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| Will you crate this animal? If so, how long?: |
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| Do you bring your animal indoors during extreme heat and or cold?: |
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| Have you or anyone in your family ever been arrested/fined or subject in an investigation involving animal cruelty?: |
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| Are you aware that the average costs a year for owning a dog or cat could be up to $1000? Are you prepared for this kind of financial responsibility for owning an animal?: |
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| Would you take this animal with you if you had to move?: |
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| Do you take your dog or plan on taking this dog on daily walks?: |
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| Do you or anyone in your family have allergies to pets?: |
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| If so, have you owned a pet in the past without it becoming a problem?: |
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| Housing |
Own house
Live in apartment (provide name and number and proof of pet deposit)
Live in Mobile/Manufactured Home (provide name and number of landlord)
Rent a house (provide name and number of landlord) |
| Housing More Information: |
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| What county to you live?: |
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| Does anyone smoke inside your home?: |
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| Do you understand that our adoption fee is non-refundable?: |
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I understand all questions and all my answers are true and accurate. I am aware that ANY false information will be immediate denial of adoption.
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