Rescue Ridge Adoption Application

Are you interested in a dog or a cat.

Name of the pet you want to adopt

Your Name *

First & Last Name

Address

Street Address
Street Address Line 2
City	State
Zip Code	Country

Your E-mail *

Home Number

Area Code Phone Number

Cell Number *

Area Code Phone Number

Drivers License Number

Do you have any pets living in the house?

Cats Dogs Other small animals (ferrets, guinea pigs, etc) spay and neutered

Have you had animals in the past?

Cats Dogs Other small animals (ferrets, guinea pigs, etc)

Were they spayed / neutered?

Yes No

Please describe animals you have now. Age, breed, sex. If you have no animals now please describe animals you have had in the past along with the name of the animals.

How long did you have them and what happened to them?

Who was/is your veterinarian?

Vet name, address & phone number

How long have you lived at your current address?

Do you:

Own Rent

If applicable, does your lease allow animals? If yes please include landlord's contact info.

Yes No

Please list the names and ages of ALL the people that live in your home. Please list people that usually stay for an extended amount of time. Along with their animals.

Does anyone in your household have allergies?

No Yes

Where will the pet be kept during the day and night?

Is anyone home during the day?

Yes No

Do you have a yard?

Yard, fenced with a vertical fence Yard, fenced with invisible fencing Yard, no fence No yard (apartment/condo/townhome)

Do you have a fenced-in yard?

Yes No

If applicable, how high is your fence?

Maximum amount of hours pet will be left alone? Where will the pet be kept when alone?

Are you financially prepared to give this animal routine and emergency medical care?

Yes No

Reference #1

First Name Last Name

Phone Number

Area Code Phone Number

Relationship

Reference #2

First Name Last Name

Phone Number

Area Code Phone Number

Relationship

Reference #2

First Name Last Name

E-mail

Relationship

Do you have any additional comments, questions or concerns? Anything else you would like us to know.

In the event you become ill, who will care for the animal?

I HAVE READ THE APPLICATION AND I AGREE TO THE ABOVE CONDITIONS

Yes

Your full name

First Name Last Name

Date *

Enter the message as it's shown *