Shelter From The Storm

Adoption Application

Last Name:

First Name:

Co-applicant (spouse, partner)Last Name:

Co-applicant First Name:

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

Do you own or rent?

Own

Rent

If rent, please include type of building (house, apartment, condo, etc) and landlord's name and phone number

Which pet are you interested in?

Dog

Cat

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 obtained/adopted from, if you still have them, if they are 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 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

Where will your dog sleep at night?

Do you plan to crate train?

YES

NO

Do you plan to attend dog training/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 will you provide excersie and potty breaks?

Fenced yard

Tie-out

Leashed walks

Other

If other, please explain:

How much exercise are you planning to give your dog?

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 list two references that are not related to you and that do no live with you. Include names, phone numbers and email addressses (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 notified within 24 hours that a volunteer from Shelter From The Storm will be calling. 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.

Shelter From The Storm Adoption Application

For Cat Adoptions Only

For Dog Adoptions Only

Shelter From The Storm

Adoption Application