Shelter From The Storm

Adoption Application

Last Name:

First Name:

Street Address

City:

State

Zip Code:

Phone No:

Email:

HOUSING: Do you own or rent? Please include type of building (house, apartment, condo, etc) and landlord's name and phone number

Which pet are you interested in?

List the people who live with you, their ages and please indicate the primary care giver for the animal you are interested in.

Have you ever surrendered or given up a pet to a shelter or other situation?

YES

NO

If yes, please describe the situation:

List all the animals that you have had in the past five years, where they were adopted from, if you still have them are they current on their vaccinations and have they been spayed/neutered?

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:

If Other: please describe

Where will the animal you are interested in spend most of their time? (Pick an answer from the drop-down box below)

What will happen to the animal if you move?

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 to declaw?

YES

NO

MAYBE

Do you plan on keeping your
cat indoors ONLY?

YES

NO

Are you willing to work on
litterbox issues if needed?

YES

NO

How often are you willing
to change the litterbox?

For Dog Adoptions Only

Where will your dog sleep at night?

Do you plan to crate train?

YES

NO

Do you plan to attend Obedience classes?

YES

NO

Can you deal with excessive shedding at least once a year?

YES

NO

Are you willing to work with housebreaking?

YES

NO

How much exercise are you planning to give your dog?

What is the name and phone number of the vet you plan to use or have used in the past?

Please list two references that are not related to you ans that do no live with you. Include names, phone numbers and email addressees (if better for contact). Be sure that these people know they will be contacted.

Please provide any further information that you feel would be helpful for your application.

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 understand that the people named in the application, landlords, veterinarians, references, etc will be contacted. I also understand that Shelter From The Storm will contact me after processing the application, which can take time. 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.


This form created at http://www.formsite.com/

Shelter From The Storm Adoption Application

For Cat Adoptions Only

For Dog Adoptions Only

Shelter From The Storm

Adoption Application