Adoption Application Form

Information provided here will help us find you the purrfect match!

Applicant Name *

First

Last

Phone *

Email *

What kind of animal are you looking to adopt? *

Do you already have a specific animal in mind? *

What is the name of the animal? *

How did you hear about this animal? *

Type of residence *

House
Apartment
Other

Other (please describe) *

Street address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Is your mailing address the same as your street address? *

Mailing address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

How long have you lived at this address? *

Number of years and/or months

Do you? *

Rent
Own
Shared Accommodation (with roommates)

Landlord Name *

First

Last

Landlord Phone *

Have you discussed having this pet with your landlord or roomates? *

Do you or anyone you live with have pet allergies? *

How many adults (including yourself) reside in the home? *

How many children reside in the home? *

How many hours per day would you be away from home? *

How often do you travel away from home? *

Who will watch and care for your pet while you travel? *

Do you currently have any pets? *

Current pet(s) information *

Please include your animals names, breed, gender, age, whether they are spayed/neautered, and if their vaccines are current.

Veterinarian name *

Veterinarian phone *

I hereby authorize my veterinarian to release any medical records requested by Critteraid *

Have you had any animals in the past 5 years but no longer have? *

Previous animal information *

Please include the type of animal, how long you had them, and the reason you no longer have them.

Are/were your current/previous animals? *

Vaccinated
Neutered/Spayed
None

Do you understand and agree to Critteraid's policy on indoor cats? *

Indoor Cat Policy

Have you done any research on the breed of dog you wish to adopt? *

Who will be responsible for the dog's care? *

Me
Someone else

Someone else (describe who) *

Can you afford regular veterinary care for your dog? *

How often will you vaccinate your dog? *

How often would you license your dog? *

Are you aware of any animal bylaws for your area? *

Would you be willing to participate in obedience training with your dog? *

Why not? *

Are you willing to keep this dog for his/her lifetime? *

Why not? *

Do you have a fenced yard? *

Height and type of fence *

Size of fence *

Small (Condo/Townhouse)
Medium (City Lot)
Large (Acreage)
Farm with Animals
Orchard

How will you keep your dog safe at home? *

Where will the dog be kept? *

Inside
Outside
Both
Other

Other (please describe) *

What type of shelter will you provide for your new pet? *

What are your reasons for adopting an animal? *

What could cause the adoption to fail? *

If your circumstances change and you can no longer keep an animal, do you agree to return the animal to Critteraid? *

I hereby declare that the information provided in this form is true and correct. I also understand that any willful dishonesty may result in refusal of this application. *

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