Animal Adoption Application Step 1 of 16 - Adoption 0% Our Process Our process does include a HOME VISIT, and for this reason, out-of-state applications can be considered on a case-by-case basis ONLY. Please take a moment to consider the following questions BEFORE submitting an application. If you answer “no” to any of the following, you are not ready to start the adoption process and should not fill out the application at this time. PLEASE READ THE FOLLOWING VERY CAREFULLY!* Are you ready to take your dog or puppy home in the next 72 hours? Do you have the approval of your entire household and landlord? If you have a pet at home already, are you certain that they are up to date on all required vaccinations? If you feel that you can do all of the above, click on the button below to start the application process.*I am ready to adoptI am NOT ready to adoptVisit our Homepage Please give the name(s) of animal(s) you are interested in.*Have you and your household met the animal(s) yet?WoofNoApplicant's Name* First Last Are you at least 21 years old?*YesNoDate of Birth* Is there a Co-Applicant?*YesNoCo-Applicant's Name First Last Relationship to ApplicantCo-Applicant's Date of Birth* Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email* Enter Email Confirm Email Primary Phone #*Alternate Phone # How long have you been at your current address?*0 - 1 year1 - 5 yearsMore than 5 yearsTell us about your home*I/We own a single family homeI/We own a condo or townhomeI/We rent our homeLandlord's Name* First Last Landlord's Email Landlord's Phone*Contact Person's Name for Condo or Townhome Association* First Last Association Email Contact Phone* How many adults in your household?*Just type in a numberHave all the adults in the household agreed to this adoption?*YesNoSection BreakNumber of children in the household?*Please enter a value between 0 and 30.Ages of children*Have the children had pets before?*YesNoIs anyone in the home allergic to pets?*YesNoWho is allergic?*Please explain the allergies? Why would you like to adopt an animal from us?* Are you employed?*YesNoEmployer*Position held*Employer's Address Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*How long have you been with your employer?*If unemployed, please explain your plan to provide for your pet financially.* Name of Reference* First Last Reference CANNOT be a family member, a person living in the same home as you or a significant other.Phone Number of Reference*Email of Reference If no email is available please leave blank Have you had or currently have a pet(s)?*YesNoHow many pet(s) have you had or currently have?*Please enter a value between 1 and 30.Pet Name*Breed*Age*Please enter a value between 0 and 30.Gender*MaleFemaleSpayed/Neutered*YesNoIf not spayed/neutered, please explain:*Where are they now?*Second Pet's Name*Breed*Age*Please enter a value between 0 and 30.Gender*MaleFemaleSpayed/Neutered*YesNoWhere are they now?*Please list information of addition pets in the same format as above.*How did you obtain your pets?*Have you ever given an animal away or relinquished an animal to a shelter?*YesNoWhat were the circumstances?* Have you had or currently have a veterinarian?*YesNoCurrent Veterinarian*Current Veterinarian's Phone #*Former VeterinarianIf applicableFormer Veterinarian's Phone #If apllicableWhen was your pet's last visit to a veterinarian and why?* How long have you been looking for a pet?*0 - 3 months3 - 6 monthsOver 6 monthsDescribe the kind of temperament you are looking for in a dog?*Are you looking for a specific breed?*YesNoHave you researched the breed of dog you have applied for?*YesNoWhat brands and form of food(s) do you plan to feed your new pet?*How often will you feed your pet?*How much time are you prepared to allow for your new pet to adjust to your home?*Are you able to afford a bill of $200-$500 (or more) for emergency vet care?*YesNoIf no, what is your plan to provide emergency care should the need arise?*How much do you plan to spend on maintenance for your pet in a year?*Are you committed to providing a responsible home for your pet's entire life (15+ years)?*YesNo If you have to move, what do you plan to do with your pet(s)?*What will you do with your pet(s) when you travel?*Who in the household will be the pet(s) primary care giver?*Where will the pet(s) be kept during the day?*Where will the pet(s) be kept during the night?*How many times per day do you plan to take your dog outside?*How do you plan to house train your dog?* Do you have a fenced in yard?*YesNoWhat type of fence do you have?*What is the approximate size of your yard?*How many hours a day will your pet be left alone?*Please enter a value between 0 and 24. How will you deal with possible digging?*How will you deal with possible barking?*How will you deal with possible chewing?*How will you deal with possible aggression?* Please provide any experience you have with pets, information you believe we should know, or any additional information you may have:Name of Applicant:* First Last CommentsThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
