My Loveable Angels Adoption Application

605 S. McClun, Bloomington, Illinois 61701

Phone 309.532.3700 myloveableangels@mail.com

Thank you for your interest in My Loveable Angels. Filling out an adoption application is not a guarantee of adopting a pet. All adopters must be at least 18 years of age. To assist in defraying care and medical expenses, there is an minimum adoption donation for all animals. MLA and the animals we serve thank you for considering our rescue to add a new family member to your home. MLA is an Illinois 501c3 not-for-profit corporation.

Personal Information

First Name *

Last Name *

Address 1 *

City *

State *

Postal Code *

Primary Phone *

Work Phone

Cell Phone

Please tell us your preferred contact number/ best time to call *

May we text you? *

If yes, please tell us the number you wish us to use If yes, please tell us the number you wish us to use

Email Address *

Employer name and phone number *

How long have you been at your current job? If less than one year, what was your last job and why are you no longer there? *

Household Information

Please list the names of everyone in your household including yourself and whether a child or adult. *

If someone in your household is allergic to the type of animal you are interest in, how do you plan to manage the allergy? *

Who will be the primary caretaker for this pet? *

Briefly describe experience with pets *

Do you *

Own

Rent

Other Other

If you rent, do you have your landlord's written permission to keep the type of pet you are interested in adopting? *

Yes

Landlord’s name: *

Landlord’s phone number: *

Describe your yard. Please be very specific and include details concerning fence, if applicable. *

Do you have a swimming pool or hot tub? *

Yes

If yes, is it enclosed separately from your yard?

Yes

How will you ensure that your pet will not be harmed due to your swimming pool or hot tub?

Does anyone other than those listed in your household come into your home on a regular basis (cleaning service, etc)? *

Yes

If yes, how will you ensure your pet’s safety when outsiders need to enter and leave? *

Other pets living in your household: Please include Breed, Age, Temperament and whether Spayed/Neutered * 🛈

How many hours a day will your pet be without human companionship? *

Where will your pet be kept when you are not home? *

Where will your pet be kept when you are home? *

How do you plan to discipline your pet? *

Have you or anyone in your household ever given up a pet? *

No	If yes, please explain If yes, please explain

Have you or anyone in your household ever lost a pet? *

No	If yes, please explain If yes, please explain

Have you or anyone in your household ever been charged or convicted of cruelty or neglect? *

No	If yes, please explain If yes, please explain

Does your community have any laws or covenants restricting the number or type of pets you may own? If yes, will you be in compliance if you adopt a pet from My Loveable Angels? *

No	If yes, please explain If yes, please explain

References:

Veterinarian’s name:

Veterinarian’s city & state:

Veterinarian’s phone:

Please list two references other than relatives:

Name:

Phone:

Relationship:

Name:

Phone:

Relationship:

Adoptable Pets

Is there a specific animal from My Loveable Angels that you are interested in adopting? *

If yes, please tell us the name If yes, please tell us the name

If this pet is no longer available, are you interested in any others? *

If yes, please tell us the name If yes, please tell us the name

Please help us find the right pet for you.

Do you prefer *

Male

Female

Either

Any other helpful notes Any other helpful notes

Is there a specific breed(s) you are interested in? *

Size of animal you prefer: *

Age of the animal you would prefer: *

Temperament of the pet you are interested in (active, calm, hyper, shy)? *

How did you learn of My Loveable Angels? *

All information and statements listed on this application are true to the best of my knowledgeable and ability. Falsification of any information for the purpose of adopting is an automatic denial.

Applicant's Signature *

Date *