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Animal to be adopted
City, State, Zip
Are you over the age of 21?
Do you work or attend school?
Please list all family members(and relation) living at this address
Children (Please give names and ages)
Why would you like to adopt a pet from us?
Companion for other pet
I am willing to make a 10-15 year commitment to my new pet.
I will take my new pet for annual veterinarian visits & vaccinations.
For approximately how many hours will your pet be alone each day?
(Without human companionship)
Where will your pet stay during the day?
Where will your pet stay at night?
Who will be responsible for the care (feeding, grooming, exercise and training) of your new pet?
Please check all that apply to your family’s lifestyle
What arrangements will you make for your pet while you are traveling?
If you rent, we must confirm that your landlord permits pets. Please provide their contact information.
Do you have any plans to move in the near future?
If yes, what do you plan to do with your pet(s)?
Please list all of the animals you have had in your home within the past 3 years
Name | Type/Breed | Age | Sex | Spayed/Neutered? | Currently in home? | If not, Why?
Please provide the name and daytime phone number of two references
Please note that missing or incorrect information will delay processing of your application. If you don’t have a phone number handy, please call or e-mail it ( firstname.lastname@example.org) when you get home. Thank you!
If you do not have a veterinary reference, do you know which veterinarian you will be using?
If so, please list
Have you ever had to give up a cat or dog, or release a pet to a shelter?
If yes, what were the circumstances?
Under what circumstances would you consider giving up your pet?
For Cats only:
Do you intend to de-claw the cat you adopt?
Do you have de-clawed cats at home?
Will your cat be allowed to go outside?
For Dogs only:
Do you have a fenced-in yard?
If not, how do you plan to exercise and/or confine your dog to your property?
If yes, how high is the fence?
If yes, what is the fence made of?
Will you seek professional help if there are behavioral problems with your new pet?
Do you have contingency plans in place for your new pet if something were to happen to you?
Please list plan
Do any members of your household have allergies?
If yes, please list
Is there anything else you’d like to tell us? Are you looking to adopt a specific type of animal?
How did you hear about SAVE?
I hereby give to SAVE, A Friend to Homeless Animals access all veterinary records of any and all animals I own or have owned. I give my consent for SAVE to contact the above listed references to inquire on the history of previously or currently owned animals. If approved, SAVE will keep this application active for six months. I certify that all the information in this application is true and I understand that false
information may void the application.
Completion of this application in no way guarantees acquisition of a pet. All adoptions are finalized at the discretion of the adoption counselors. SAVE reserves the right to deny approval of any adoption.
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