Adopter Profile

Adopter Profile
Thank you for your interest in adopting! We will do our best to help you find the right pet for your home. If there isn’t a pet currently in the shelter that you are interested in adopting, we will keep your profile on file temporarily. If you are approved to adopt, we will ask you to provide a valid form of identification that includes your address.

We will ask you to provide a valid form of identification that includes your current address.

Physical Address *

About You
Which pet(s) are you interested in? *
Or just put what you're looking for (i.e. "large dog" or "female cat")
Is this your first pet? *
Do you have other pets that you own or reside with you at your place of residence? *
About my resident pets

All are spayed or neutered Some of my pets are not spayed or neutered Up to date on their rabies vaccinations Up to date on vaccinations other than rabies All are indoors-only Some are indoors and some are outdoors All are outdoors-only Mostly inside but go outside for potty breaks
Please elaborate
Do you already have a veterinarian?
If yes, who?
Vet's phone, if known

Area Code Phone Number

What do you plan on doing with your pet?

	Yes	No	Haven't decided yet
Companion
Outdoor activities such as jogging, etc.
Hunting or mousing
Certification as therapy pet
Emotional Support Animal
Guarding
Field work such as search & rescue

About The New Pet
The new pet will spend time in: (mark all that apply)

Home Garage Basement Yard Outdoor Only Indoor Only Barn
How many hours will the pet usually be left alone each day? *
Is this pet intended to be a gift? *

Would you like to talk to staff about any of the following concerns?

	Yes	No	Unsure
Litter box/house/crate training
Declawing
Vet care
Grooming/nail trimming
Flea/tick/heartworm prevention
Diet & nutrition
Pets & kids
Introducing pets
Puppy- or kitten-proofing your home
Chewing
Senior pet care
Finding a trainer
Exercise
Pulling on leash
Pet's health

Do you have any other questions for us you’d like us to note?
May we add you to our newsletter list? *

Yes, please No thanks
Have you or any one in the pet's future household ever been arrested, charged or convicted for animal cruelty or animal hoarding? *
I've read this and I've: *
May we add you to our newsletter email list? *

Yes, please! No thanks.
I acknowledge that all the above information is accurate to the best of my knowledge. I understand that any willful misrepresentation will result in termination of the adoption process. By signing below, I also verify that neither I nor any member of the household has been convicted of animal cruelty, neglect or abandonment. I understand that this is only an application and no adoption will take place until it is approved and an adoption contract is completed and signed. I understand that this organization reserves the right to refuse adoption to anyone. *This institution is an equal opportunity employer and provider.
Name *
Signature *

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Date *

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