Application to Adopt To adopt one of our pets, you can either fill out the form online below or print and submit a paper copy of the Application to Adopt (This is a PDF file and you will need Adobe Reader to open it. Download your free copy here.) Name of animal you are interested in adopting.*Is the animal a cat or dog?*CatDogDate* Date Format: MM slash DD slash YYYY Your First Name*Your Last Name*Email* Phone*Address* Street Address City State / Province / Region ZIP / Postal Code Type of residence*HouseCondoApartmentMobile homeOtherIf you rent, please provide landlord's name:If you rent, please provide landlord's telephone number:How long have you lived at your current address?*If less than one year, your previous address:Are you planning to move within the next six months?* Yes No If you do move in the future, what will you do with your pet?*Your occupation*Company name*Business PhoneLength of employmentName of spouse or other adults in your homeNumber of childrenAges of childrenOccupations of spouse/other adultCompany nameBusiness phoneLength of employmentWho will be responsible for the pet?* Self Spouse Other adult Children Other If other, please explain:Please fill out this section of you are applying to adopt a CAT:Why are you adopting a cat?* pet companion companion for other pets for children gift If you indicated gift, does the receiver know about it? Yes No Where will your cat be kept during the day?* loose in house crate basement outside inside/outside other If other, please explain:Where will your cat be kept during the evening?* loose in house crate basement outside inside/outside other If other, please explain:If you are applying for a cat, will it be let outside?* Yes No Please fill out this section if you are applying to adopt a DOG:Why are you adopting a dog?* pet companion companion for other pets for children gift Where will your dog be kept during the day?* loose in house crate/kennel in house basement outside in fenced yard outside in kennel other If other, please explain:Where will your dog be kept during the evening?* loose in house crate/kennel in house basement outside in fenced yard outside in kennel other If other, please explain:Do you have a completely fenced in yard?* Yes No Height of fenceIf you don't have a fenced yard, how will the dog go outside? taken for a walk tied up loose in kennel loose in yard Other If other, please explain:How will you housebreak your dog?*If needed, are you willing to crate train?* Yes No If needed, are you willing to obedience train?* Yes No On average, how many hours will the dog be left alone each day?*On average, how many hours will the dog be left alone each evening?*Current & Previous PetsDo you currently own pets?* Yes No If you currently own pets, please list them by name, age, how long owned, breed, sex, and if whether he or she is neutered or spayed:*Are all of your pets up to date on their shots and exams?* Yes No If you currently own pets, please provide the name and telephone number of your veterinarian.*Are you willing to let us call your vet's office to see if your pet's shots are up-to-date?* Yes No Will you use this vet for your new pet?* Yes No If not, who will you use?*Dogs and cats often live longer than 15 years. Are you prepared to take responsibility for this pet for its entire lifetime?* Yes No It may take your pet a month or longer to adjust to a new home. Are you willing to allow this much time for adjustment?* Yes No Are you willing to allow time for your pets to adjust to one another?* Yes No, I will immediately return the pet Do you agree to return the pet to the adopting agency if you can no longer keep it?* Yes No Are you willing to let a representative of the adopting agency visit your home by appointment?* Yes No Have you ever adopted a pet from any Humane Organization in the past?* Yes No If yes, name of the shelter or organization?*Have you ever released an animal to any shelter?* Yes No If yes, what was the reason?*Is there anything you would like us to know about you or the home life you would be able to offer to an animal needing a forever home? This iframe contains the logic required to handle Ajax powered Gravity Forms.