Adoption Application Coffee Cup

Adoption Application

Fill out application to entirety, once submitted, allow a day or two for a volunteer to go over application and contact you. As always thank you for wanting to adopt!

Pet's name you are applying for:

Name & Your Age

Address

City

State

Zip Code

Home #

Cell #

Email

Employer

Occupation

Income

Will you allow a volunteer to do a home visit to determine if it's the best match for the pet you are applying for?

Type of home

Home Value

Approximate Square Footage

Do you rent or own your home?

Is your yard fenced?

If yes what type of fence, if no how will you exercise your dog?

Will he or she be allowed in every room? (Explain)

Number of adults & age of adults in home

Number of children in home

Ages of boys

Ages of girls

If you rent, please answer the following:

Are pets allowed?

Deposit required?

Any size restrictions?

If we may contact your landlord to verify, please give us their name & contact number:

Have you had any pets in the last five years?

If yes, tell us about the pets in the past 5 years. Age, breed, indoor or outside.

Are your pets current on vaccinations?

Are your pets current on heartworm prevention?

What brand and how often administered?

Have you ever adopted from a rescue?

Will there be an adult home during the day?

How many hours will the pet be alone?

Where will the pet stay when alone? (be specific)

Where will the pet stay when you are home?

Where will the pet sleep at night? ( Be specific)

If you were to move, what would happen to your pet?

Do you intend to microchip your pet?

Do you understand that when a dog comes into new surroundings the dog can have pottty accidents untill they are comfortable?

Have you ever potty trained a new pet?

Current Vet name and number:

Standard medical care costs can be expensive each year and emergency vet care can cost hundreds to thousands just depending on your pet's medical condition. Are you willing to provide standard and emergency care for this pet?

Why do you wish to adopt this pet?

Please give 3 personal references:

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