First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone

Why are you interested in adopting a pet at this time*

Which animal are you interested in
Choose an animal: Archie (must be adopted with Rufus) Baby Cali Fauna Gabby Gadget Gracie Huckleberry Kai Kerrigan Loki Meatball Moon Nala Nala *Courtesy post* Oreo Pandora Pepsi Pippin Ranger Rocky Rufus (must be adopted with Archie) Sir Edwin Smokey Thomas Thomas Toph

What traits are you looking for in a pet (Select all that apply)?

Will the animal be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

Is your yard fenced*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

What is the height of the fence*

For cats only: Is declawing an option for you

Describe how you will train the pet*

Will this pet wear an ID collar*

May we contact your veterinarian?*

Veterinarian's Name and Phone Number*

Do you own or rent your home*
Choose one: Rent Own

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

If you rent, have you received the approval of your landlord to have an animal
Choose one: Yes No

If you rent, please enter your landlord's name and phone number. Otherwise, enter N/A*

How many people reside in your household*

What are the ages of children in your home, if any*

Are any members of your household allergic to animals*

Who in the household will care for the pet*

Do you understand the costs involved with pet ownership (e.g., food, veterinary care)*

Are you willing to provide medical care if this animal should become sick or injured*

Under what circumstances would you not keep this pet*

What will happen to your pet if your pet outlives you*

Have you ever given up a pet? If yes, please explain*

Please list any pets you have owned in the last 5 years, whether they were altered and vaccinated, and what has happened to this pet*

Would you be agreeable to a home visit or follow-up call*

I certify that I am at least 18 years of age*
Choose one: Yes No

I certify that the information entered on this applicant is true. Enter your name and date*