Dog/Cat Adoption Form

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Personal Information
E-Mail:*		Valid e-mail is required
First Name:*
Last Name:*
Spouse/Partner/Housemate Name:
Address Line 1:*
Address Line 2:
City:*
State:*
Zip Code:*
How long have you lived at your current address?*
If less than three years, please list previous address?
Marital Status:
Gender:
Date of Birth:
Phone:*
How many children live in the home:*
Ages:
How many adults live in the home :*
Do all adults work outside the home:*	Yes No
Do you:*	Own your property Rent your property Live with your parents
If renting, does lease allow for pets?	Yes No
If renting, please provide landlord`s name and telephone number:
Adoption Related Information
Which pet are you interested in?*
Reason for adopting a cat or dog:*		you may choose more than one
Do you have a fenced in yard?*	Yes No
Do you currently own a pet?*	Yes No
Please list all companion animals you currently have:		include type of pet & age
Where will this pet spend most of it`s time?*
How many hours a day will your new pet be without human companionship?*
Pets usually require minimum cost of $500 per year for veterinary care, food, and other related expenses.
Are you willing and able to afford these costs?*	Yes No
Have you ever had to give up or find another home for a pet in the past?*	Yes No
If yes, please explain?
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