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Dog / Cat Adoption Application


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Animal Impound Number:
Cage Number:
Available Date:
Description of Animal:
Staff:
Today's Date:
In order to be considered for an adoption today, you must be at least 18 years of age (current ID) and own your home, or have written permission from your current landlord. You must be willing to supply a lifetime of love, attention, and medical care. Pet ownership is a responsibility that shouldn't be taken lightly. In our effort to find the best possible home for each animal, we ask that you fill this application out completely and expect to spend time discussing it with one of our representatives. We also ask that you spend time with the animal you're interesed in before requesting an application. Applications generally take 24 hours to approve. Failure to provide any necessary information within the first 24 hours of submission may void the application. Your application can be completed here and submitted online. However, our adoption process is still 'First come, First served'. Whoever is here first on the day the animal becomes available, will have their application reviewed first
Have you submitted an application in the past?
Yes
No
How did you hear about our shelter or the animal you are interested in?
Adopter's Name:
Email Address:
 
Phone:
Mailing Address:
Physical Address (if different):
City, State/Zip
Employer / Phone:
Drivers License # / State / Expiration:
Date of Birth:
Number of Children Living in Household; Ages:
Do you:
Own House
Rent House
Rent Apt
Are pets allowed?
Yes
No
Unsure
Landlord's Name / Phone:
How long have you lived at your present address?
Are you planning to move in the next 6 months?
Have you ever had to move?
Did you take your pets with you?
If you have to move in the future, what will you do with your pets?
Who will be responsible for the pets care?
Is there anyone in the household that does not want a pet?
Does anyone in the household have animal allergies?
Have you ever owned a pet before?
yes
No
If yes, what happened to it?
How long did you have it?
Was it spayed or neutered?
What pets do you currently own? (list all please, including breed, name, and whether they are altered)
Pet #1:
Pet #2:
Pet #3:
Pet #4:
Pet #5:
Have you ever been forced to take an animal to a shelter or a pound before?
Yes
No
If yes, why:
Who is your current Veterinarian / Phone?
*In case we need to reach you for a follow-up on the adoption, please provide additional contact person, friend or relative, who does not live with you:
Name:
Phone:
PET SELECTION
What is your main reason for wanting a pet?
Check all that apply:
House Pet
Mouser
Companion
Watch dog
Friend to existing pets
For the Children
Other
Check all that apply:
Feisty
Active
Shy
Affectionate
Playful
Quiet
Gentle
Independent
Protective
I would like my new cat to get along with:
Cats
Dogs
Children
KEEP IN MIND THAT SOME PETS (PARTICULARLY CATS) MAY GROW UP TO BE ALOOF, NO MATTER HOW MUCH LOVE AND AFFECTION YOU GIVE THEM!
Do you believe in spaying or neutering your pets?
Why or why not?
Where will your pet spend most of it's time?
Will this pet be allowed in the house?
How long will it be left alone each day?
Where will is sleep at night?
If outside, what kind of shelter will you provide for it?
If a dog, how will you keep the anima secured to your own property (fence, kennel, tether, garage, training, etc)?
What kind of fence, kennel, tether, or training do you have or plan to use?
Do you plan to keep ID on your pets (license for a dog, tag for a cat, or microchip for either)?
If you adopt a cat and plan on keeping it outside, can you agree to the importance of keeping an adult cat inside for the first month, and a kitten inside until it reaches adult size (appx 1 year)? This includes the next time you move.
Yes, I agree.
How long do you plan on keeping this pet?
If you had to give up the pet, what would you do?
I CERTIFY THAT ALL THE INFORMATION IN THIS APPLICATION IS TRUE AND I UNDERSTAND THAT FALSE INFORMATION MY VOID THE APPLICATION. LAKE COUNTY ANIMAL CARE & CONTROL RESERVES THE RIGHT TO DENY ANY ADOPTION APPLICATION FOR ANY REASON.
Typing your name in the box provided below will be considered the same as a signature
Signature:
Date: