Adoption Application

Your Information

Part 1 of 4
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Name of the animal you wish to adopt?*
Household Information

Part 2 of 4
How many people in your household?*
Full name and age of each person*
How many animals in your household?*
Name, species, breed and age of each animal in your household*
Type of Home?*
Please describe*
Do you rent or own?*
- Rent
- Own
Do you have a HoA or similar property restrictions?*
- Yes
- No
Optional: Upload a copy of your lease/rental agreement
Optional: Upload a copy of your HoA rules regarding pets
Do you have a yard?*
- Yes
- No
Is the yard fully fenced?*
- Yes
- No
Is there a car gate to the yard?*
- Yes
- No
Is there a swimming pool?*
- Yes
- No
Income and References

Part 3 of 4
Approximate yearly income*
Primary source of income?*
Other, please describe*
Employer name, location and contact information*
Name of your company, and what do you do?*
How many years have you lived at your current address?*
Did you rent or own your previous home?*
- Rent
- Own
Previous Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Former landlord's name
First Last
Former landlord's phone
Do you anticipate moving within the next 5 years?*
- Yes
- No
Where to?
Why do you expect to move?
Personal References

Two persons NOT related to you:
First Reference
First Last
First Reference Phone
First Reference Email
Second Reference
First Last
Second Reference Phone
Second Reference Email
Pet Information

Part 4 of 4
Where will you pet live?*
- Outside
- Inside
How often will your walk your pet?*
Where will your pet sleep at night? (Check all that apply)*
- Outside
- Living room
- Kitchen
- Bedroom
- Dog house
- Crate
- Pet bed
- My bed
- Family member's bed
When you travel or go on vacation, where will your pet stay?*
Should you have an emergency, who would look after your pets?*
Do you plan to obtain pet health insurance?*
- Yes
- No
What brand of insurance?*
What brand of pet food do you plan on using?

Posted on November 3, 2018 by Free Animal Doctor.

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Adoption Application

Your Information

Part 1 of 4

Household Information

Part 2 of 4

Income and References

Part 3 of 4

Personal References

Two persons NOT related to you:

Pet Information

Part 4 of 4