Shelter From The Storm Adoption Application
Last Name:
First Name:
Co-applicant (spouse, partner)Last Name:
Co-applicant First Name:
What county do you reside in?
Street Address
City:
State
Zip Code:
Phone No (with area code):
Alternate Phone No:
Email:
Our primary means of communicating with you will be via email. If you haven't heard from us within 24 hours, please check your spam filter/folder.
Have you applied or adopted from Shelter From The Storm before?
YES
NO
List the complete names of all the people who live with you, their ages and indicate the primary care giver.
List current employer and telephone number.
How long have you worked there?
Do you own or rent?
Own house
Own condo
Rent house
Rent apartment
Rent condo
If rent, provide name of landlord and telephone number.
Which pet(s) are you interested in?
Dog
Cat
Have you ever surrendered or given up a pet? (If yes, explain why, when, what happened, etc. in comments section at the bottom.)
YES
NO
Provide us with the following information all the pets you've had in the last 5 years.
Pet 1
Pet 2
Pet 3
Pet 4
Pet 5
Name of Pet & Type (dog, cat, etc)
Spayed or Neutered? (yes or no)
Vaccinated? (yes or no)
Still have? (yes or no)
Are you willing to take responsiblity for unexpected veterinary fees ($300 + a year) due to ear infection, upper respiratory infections, parasites etc.?
YES
NO
Why are you adopting a pet? Check all that apply:
Companionship
For the children
Mouser
Guard dog
Farm worker
Breeding
Hunting
Other
If Other: please describe
Where will the animal you are interested in spend most of their time?
(Select answer from the drop-down box below)
Inside
Outside in a kennel
In a barn
In a garage
Tied up outside
Outside loose
In a fenced yard
Other
What will happen to the animal if you move?
What is the name and phone number(s) of the veterinarian(s) you have used in the past or plan to use? Please include area code. Please notify your vet clinic that we will be calling.
How will you transport the animal to the vet and other necessary places?
What do you feel is an acceptable reason to give up a pet?
For Cat Adoptions Only
Do you plan on keeping your
cat indoors ONLY?
YES
NO
Do you plan to declaw?
YES
NO
MAYBE
If you have other cats, do you have means to keep the new cat separated to introduce them slowly?
YES
NO
Are you willing to work on
litterbox issues if needed?
YES
NO
How often are you willing
to change the litterbox?
If you already have a cat, it is best to add at least one additional litter box.
For Dog Adoptions Only
Do you agree to obey all applicable leash laws and licensing laws in your area?
YES
NO
Where will your dog sleep at night?
Do you plan to crate train?
YES
NO
How will you provide excersie and potty breaks?
Fenced yard
Tie-out
Leashed walks
Other (if other, explain in comments below)
Can you deal with excessive shedding at least once a year?
YES
NO
Are you willing to work with housebreaking?
YES
NO
Do you plan to attend dog training/obedience classes?
YES
NO
How much exercise are you planning to give your dog?
List the names, telephone numbers, and/or email address of two personal references not living with you and not related to you.
Name
Telephone
email
Reference #1
Reference #2
Please provide any comments or further information you feel would be helpful.
By signing below with my initials:
I certify that all the above information is true to the best of my knowledge and I recognize that any misrepresentation will result in the loss of adoption privileges.
I will notify the people named in the application (landlords, veterinarians, references, etc.) within 48 hours that a volunteer from Shelter From The Storm will be contacting them via email or phone.
I understand that by submitting his application, it is a not a guarantee I will get to adopt the animal I am interested in and the Shelter From The Storm has the right to decline or accept any application.
I acknowledge that Shelter From The Storm has the right to determine the best applicant for any animal.
I understand that Shelter From The Storm will contact me after processing the application and that I might be contacted with questions. During this time I will reconsider my lifelong commitment to the animal that I have selected.
Enter your initials here. This qualifies as your signature.