Adoption Application 2024

Which cat(s) or dog(s) are you interested in:*

How did you find out about our rescue?*

Name*

First NameLast Name

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

Your home is:*

HouseApartmentCondo/TownhouseOther

My residence*

I am the ownerI rent my homeOther

If you are renting, please provide landlord name and contact info:

Who will be the main caregiver of the cat/dog?

Are all parties of the household on board and willing to help with the care of a new addition?*

YesNo

If adopting a kitten/cat, will you be declawing?*

How would you handle destructive behavior? (cat -scratching or urinating out of box or dog - accidents in the house, excessive barking)*

Check all that apply. Who do you live with?

Please list: FULL NAME (INCLUDING SELF), AGES, RELATIONSHIP of all people who live in the household*

FULL NAME, AGE, RELATIONSHIP (INCLUDING YOURSELF)

Describe the kinds of personal situations where you may have to return your adopted cat or dog, e.g. moving, job loss, children, marital change, etc*

If yes, please explain

Cat/Dog Living Situation and Lifestyle - where will the pet live?*

InsideOutsideCombination

Where will your pet stay during daytime hours?

Where will your pet stay/sleep during nighttime hours?

What arrangements will be made for your pet when you are traveling?

If adopting a dog, what type of fencing do you have?

Privacy fence/Physical fencingInvisible FenceNo fenceOther

Home setting:*

UrbanSuburbanRuralOther

Describe all pets you have owned in the last FIVE years:

	Name	Type (cat/dog/?)	Breed (if dog)	Age	Sex	Spayed/Neutered	On heartworm preventative?	Indoor/Outdoor	Where is pet now?	If deceased, please explain	If deceased, date passed away
Pet 1
Pet 2
Pet 3
Pet 4
Pet 5
Pet 6

Have you ever had an application declined for adoption of an animal from an animal welfare group/animal control center?*

YesNo

If yes, please explain

How many hours per day will your pet be alone?*

Do you understand this is a 10-20 year commitment, the lifetime of your pet?*

What kind of veterinary care do you plan to provide?*

If administering heartworm preventative, please indicate where you purchase from if not from the vet practice listed. *Proof of purchase is required.

VET REFERENCES:

Name of Practice:

Name of Vet:

Phone # of Vet:

Name and phone # vet records are listed under:

Any other info that would be helpful for us to know

Are you prepared to spend $500 or more in the event of an emergency vet visit?*

YESNO

Pets can live many years. If your pets were to outlive you, what would happen to them? *

CURRENT PETS IN HOUSEHOLD: We require all pets in adopters home to be up to date on veterinary care. A veterinary reference WILL BE CONTACTED. If any pets in the household are behind on veterinary care, this will result in a denied application. By checking this box I agree/confirm all pets in my household are up to date on vaccines and preventative care.

Pets in Household:

My current pets are up to date on vaccines.I do not have any pets currently.

I have read the above information carefully and have filled out this application truthfully. I understand that omission of information, false information and/or failure to answer all questions can result in this application being denied.

I understand that my name and date below represent my signature for the purpose of this application.

NOTE: Many vets now require owner's permission to disclose vet history. Please contact your vet to tell them a representative from Vintage Racers for Rescues will be calling for this history so that the processing of your application will not be delayed.

Your full name:*

Date*

Date