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ADOPTION APPLICATION
***All questions must be answered***
Thank You.

Today's Date

Full Name
(First and Last)

Spouse or other party name
(First and Last)
 

Home Address
(No PO Box)

City, State, Zip

Home Tel#

Cell Tel#

Work Tel#

Email Address

Place of Employment
(Name and address)

What is the best way and time
to contact you?

What is your age?

What type of animal are
you interested in adopting?

Which pet are you
interested in adopting?

Why do you want to
adopt a pet?

Does anyone living in your household
have any known allergies to animals?

Yes
No

If so, what kind of allergies?

Have you owned a pet before?

Yes
No

What pets currently
live in your household?

Are your pets kept indoors or outdoors?
(Explain)

Please list the pets you have had within the past 5 years and explain what happened to them.

Are your pet(s) spayed and neutered?

Yes
No

If not, please explain why.

Are your current pet(s)
 up to date on all vaccinations?

Yes
No

If not, please explain why.

Do you have a veterinarian?

Yes
No

If so, please identify:
Name/Clinic, Phone number,
address

Will you allow above named Vet to release information regarding all current and former pets to Animal Rescue and Kare?

Yes
No

Does everyone in the household know you are planning to adopt a pet?

Yes
No

Do you own your home, rent your home/apt, or live with parents? 

Own your home
Rent your home/apt
Live with parents

If renting, who is your landlord
and give their phone number.

If you rent, does your landlord allow pets?

Yes
No

How long have you been at this address?

Any children?
What ages?

Do you have a completely
fenced in yard, if so what
kind and how high?

If the cat or dog will be allowed
outdoors, how do you plan
to make it clear to the animal
 that this is its new home?

How long do you plan to
keep this pet?

Should you move unexpectedly
 what will become of the pet?

What behaviors would you consider
unacceptable in your pet?

How would you correct these behaviors?

Do you agree to keep your pet on a
leash while outdoors and off your
property as required by local
and state laws? 
 

Yes
No

How will you keep your dog confined to your property?

How many hours a day will your pet be alone?

Where will the pet stay when alone?

Where will the pet sleep?

If you travel, how will your pet be cared for?

If outdoors, what kind of shelter will be available to protect the pet from the elements?

Who will financially support this pet?

Do you plan on spaying or neutering the pet you want to adopt (if not already altered)?

Are you prepared for the costs involved in properly caring for a pet (ex. food, treats, toys, grooming, shots, etc.)?

Are you aware that if you adopt a pet from our rescue, you are required to return the pet to us at your own expense if you can no longer keep it?

Yes
No

Would you object to an authorized member of ARK inspecting your residence?

Yes
No

Please list at least 2 References (must include name, phone number, and address)

How did you hear about Animal Rescue & Kare and our adoption services?

If "INTERNET", please tell us from what site you found us.

Have you adopted a pet from us before or any other rescue organization?

Yes
No

If so, which pet did you adopt from  us?

Which other rescue/organization have you adopted a pet from?

Anything else you think we might need to know or you want to tell us?

If you are not a local adopter, would you be able to pick up the pet?

Yes
No

All of the information I have provided is true and complete to the best of my knowledge. I agree to provide the pet with adequate food, water, shelter, affection and medical care.

True
False

Do you understand that We reserve the right to refuse any adoption to any person for any reason?

Yes
No

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