Moonracer Adoption Application

Adoption Application
What animal are you interested in adopting?*
Your name*
First & Last Name
Your Address*

Street Address

Street Address Line 2

CityState

Zip Code
Your Email*
Your Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
Employer*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Names and ages of all residents of your home (adults/children)*
Please list any pets currently living in your home, and if they are vaccinated and altered.*
Vet reference (please call your vet and give notice that we will call. If you have not been to a vet before, please register with one soon.)*
Vet name, address & phone number
Will you allow Moonracer to visit your home prior to approving your adoption application?*

YesNo
Are you planning to move in the near future?*

YesNo
If moving soon, to what city/state?
When will you be ready to adopt this animal?*

TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Is anyone in your home allergic to the animal you're planning to adopt?*

YesNoYes, but it is tolerable for them and they are OK with it.
Are you familiar with the breed?*

YesNo
You live in a:*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you rent or own this property?*

RentOwn
Landlord*
Landlord Phone #*

Area CodePhone Number
If you rent, you must give Moonracer No Kill Animal Rescue a written letter from your landlord or a copy of the section of your lease stating that you are allowed to have this type of animal and showing any limitations.

If you live in a condo or townhome, you must show us written proof that you are allowed to have this type of animal there and show any restrictions.
How long at this address:*
Previous Address (if less than 2 years)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Do you have a yard?*

Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.
If applicable, will your children be taught how to play gently and kindly with this animal?*

YesNoNo children
Have you ever had to give up a pet?*

YesNo
If yes, explain
Vet bills can be expensive. How do you plan on paying them? (IE: Pet health insurance)*
Reference (Other than a family member)*
Do you have any additional comments, questions or concerns?
By checking the box below, you understand the terms of this form and adoptee. You hereby agree that you will not use this animal in any sort of fighting or cruelty. You will love and care for this animal for the rest of its life, and you are ready to commit to that. You also agree, that if for any circumstances you can no longer provide love and care for this animal, you will contact Moonracer No Kill Animal Rescue and explain your situation before rehoming or taking the animal to a shelter.

I understand the above, and have tried to the best of my knowledge to make sure all information is correct.
Adopter's Signature*
Signature date*
Thank you for taking the time to submit this form. After you click the Submit button, you will recieve a confirmation email. Thank you!
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