Adopt Application

Adoption Application

CASA DE LOVE ANMAL RESCUE
DESCRIPTION OF PET
Date

MonthDayYear
Date
Pet Name
INFORMATION ABOUT YOUR ENTIRE FAMILY
Person 1 Name*

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone*

Area CodePhone Number
Cell Phone*

Area CodePhone Number
E-mail*
Person 2 Name

PrefixFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
E-mail
example@example.com
Please supply a list of all adult’s name and age who live in the house:
Do you have children?

YesNo
Child #1 Name
Age
Experience with Pets?

YesNo
Child #2 Name
Age
Experience with Pets?

YesNo
Child #3 Name
Age
Experience with Pets?

YesNo
HOME INFORMATION
Do you..

Own your home?Rent your home
Do you have authorization in your lease, rental, or homeowner's association contract to have indoor and outdoor pets?

YesNo
Do you have authorization in your lease, rental, or homeowner's association contract to have dogs of ANY BREED?

YesNoNo breed limitations, but we do have size limitationsOther
Landlord, Manager or HOA Contact:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Email
example@example.com
GENERAL PET INFORMATION
Veterinary Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
How many pets have you had in the past?
Have you ever had to give up one of your pets?

YesNo
If yes, please explain in detail
Our adoption contract will require that you agree to never surgically or permanently alter the appearance of a dog who is adopted from Casa De Love. Do you agree to these terms?

YesNo
Do you have pets now?

YesNo
If yes, please provide Pet #1 's name
Species/Breed
Indoor?

YesNo
Sex

MaleFemale
Age
Vaccinated?

YesNo
Altered?

YesNo
Pet #2 's name
Species/Breed
Indoor?

YesNo
Sex

MaleFemale
Age
Vaccinated?

YesNo
Altered?

YesNo
Pet #3 's name
Species/Breed
Indoor?

YesNo
Sex

MaleFemale
Age
Vaccinated?

YesNo
Altered?

YesNo
REFERENCES
Reference #1 Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship
Reference #2 Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship
ADDITIONAL QUESTIONS
Do you have a secure fenced backyard?

YesNo
How high is the fence?
How long will you be away from your pet on a daily basis?
What will you do with your pet while you are gone?
How will you exercise your pet?
Where will your new pet sleep at night?
What do you think makes this particular pet a good choice for you?
Have you had experience with this particular breed?
Do you understand that dogs sometimes take several weeks or months to adjust to their new home?
Are there any other comments you would like to add?
I certify that the above information is true and accurate to the best of my knowledge, and that I have willingly provided it to Casa de
Love Animal Rescue. I will notify Casa de Love Animal Rescue of any changes related to this information.
Signature of Applicant*

Clear
Date Signed*

MonthDayYear
Date
Print Name*

First NameLast Name
Signature of Co-Applicant

Clear
Date Signed

MonthDayYear
Date
Print Name

First NameLast Name
Signature of CLAR representative

Clear
Date Signed

MonthDayYear
Date
Print Name

First NameLast Name
Should be Empty:

Adoption Application