Adoption Application

DO YOU WISH TO ADOPT A: *

DOG CAT

NAME OR DESCRIPTION OF PET YOU ARE APPLYING FOR? *

YOUR FULL LEGAL NAME *

First Name Last Name

Your E-mail Address

HOME PHONE#

Area Code Phone Number

CELL PHONE # *

Area Code Phone Number

MAILING ADDRESS: *

PHYSICAL ADDRESS: *

Prefered Contact? *

HOME PHONE CELL PHONE

EMPLOYER'S NAME *

EMPLOYER'S PHONE NUMBER *

YEARS OF EMPLOYMENT WITH CURRENT EMPLOYER? *

DATE OF BIRTH: *

DRIVER'S LICENSE # AND STATE: *

DO YOU PLAN TO USE THIS ANIMAL FOR SPORTING, SHOWING, HUNTING, OR JUST A LEISURE FAMILY PET? IF YES TO ANYTHING BUT FAMILY PET WHAT SPORT OR EVENTS? *

HOW DO YOU PLAN TO CONTAIN YOUR PET? *

HOUSE PET FENCED YARD RURAL AREA/ACREAGE CHAIN OR TIE OUT OTHER

IF OTHER PLEASE EXPLAIN BELOW:

DO YOU HAVE A FENCE? TYPE OF FENCE (MATERIAL)? HEIGHT? HOW MANY GATES AND ARE THEY LOCKABLE? *

HOW MANY PETS DO YOU CURRENTLY OWN? *

PETS AGES? GENDERS? BREEDS? *

ARE YOUR CURRENT PETS SPAYED OR NEUTERED? *

IF NOT WHICH AREN'T, AND WHY?

ARE YOUR PETS UP TO DATE ON VACCINATIONS, WORMING,AND HEART WORM PREVENTATIVE? *

IF NOT WHICH AREN'T, AND WHY?

HAVE YOU EVER SURRENDERED AN ANIMAL TO A POUND OR SHELTER? *

IF YES REASON FOR DOING SO?

PLEASE CALL YOUR VETERNARIAN AFTER COMPLETING THIS APPLICATION AND GIVE 3 GIRLS ANIMAL RESCUE PERMISSION TO ASK QUESTIONS ABOUT YOUR ANIMALS. THANK YOU.

VETERINARIAN'S NAME, ADDRESS, PHONE NUMBER. *

HAVE YOU EVER ADOPTED FROM US BEFORE? WHEN? NAME OF PET?

HAVE YOU EVER ADOPTED A PET FROM ANOTHER SHELTER OR RESCUE? IF YES NAME OF SHELTER OR RESCUE.

DO YOU RENT OR OWN YOUR HOME? *

RENT OR LEASE OWN OTHER

IF OTHER PLEASE EXPLAIN:

IF YOU RENT OR LEASE, WE MUST HAVE YOUR LANDLORD'S NAME AND PHONE NUMBER. FAILURE TO PROVIDE US THIS INFORMATION WILL VOID YOUR APPLICATION AND IT WILL BE CONSIDERED INCOMPLETE.

IF RENT, LANDLORD'S NAME AND PHONE NUMBER:

ARE THERE ANY CHILDREN IN THE HOME? IF SO AGES? *

ARE YOU PREPARED TO ACCEPT THE MORAL, LEGAL, AND FINANCIAL RESPONSIBILITIES OF OWNING A PET? *

YES NO

HOW MANY HOURS A DAY WILL THE PET BE LEFT ALONE? HOW MANY DAY'S A WEEK? HOW WILL THE PET BE CONTAINED WHILE ALONE? *

PLEASE LIST TWO PERSONAL REFERENCE'S NOT RELATED TO YOU AND THEIR NUMBERS: *

I UNDERSTAND THAT I AM APPLYING FOR ADOPTION OF AN ANIMAL THROUGH A RESCUE. THESE ANIMALS HAVE COME FROM RESCUES, POUNDS, OR SHELTERS: 3 GIRLS DOES NOT FULLY KNOW THE ANIMAL'S HISTORY OR BEHAVIOR BEFORE IT CAME INTO THEIR CARE. I UNDERSTAND THAT ALL ANIMALS WILL TAKE TIME FOR ADJUSTMENT INTO THEIR NEW HOME AND LIFE. BY COMPLETEING THIS FORM I ALSO UNDERSTAND THAT APPLYING FOR SAID ANIMAL MEANS IN NO WAY THAT I AM AUTOMATICALLY APPROVED FOR ADOPTION. IF APPROVED I WAIVE ALL LIABILITY AND RESPONSIBILITIES OF SAID ANIMAL FROM 3 GIRLS ANIMAL RESCUE AND WILL BE RESPONSIBLE FOR THE ACTIONS OF THE ANIMAL FULLY ONCE IN MY POSSESSION. I GIVE 3 GIRLS ANIMAL RESCUE ALL RIGHTS TO RECLAIM THE ANIMAL AT ANYTIME IF THEY FEEL IT ISN'T BEING CARED FOR PROPERLY. IF I FEEL THE ANIMAL DOESN'T WORK IN MY HOME I WILL CONTACT 3 GIRLS ANIMAL RESCUE FOR THEM TO REGAIN POSSESSION OF SAID ANIMAL WITHIN A REASONABLE AMOUT OF TIME. I UNDERSTAND THAT THEY ARE A FOSTER ONLY RESCUE AND WILL NEED TIME TO COME UP WITH AN AVAILABLE FOSTER FOR PLACEMENT.

I fully understand and agree that the final decision of an Approval or Denial is the SOLE and Final decision of the "Board of Director (s) INITIAL___________Date:________

This MUST be initialed and Dated before this application will BE considered.

SIGNED ELECTRONICALLY BY: *

DATE: *

3 Girl's Animal Rescue- Adoption Application