Adoption Application Which pet are you applying to adopt? (required)*Is it a:DogCatHow did you first hear about this dog/cat?Pupandcatco.com websiteFacebook postPet was at adoption eventInternet search for adoptable dogsPetfinder.comRefered by a friendOtherFirst and Last Name (required):* First Last Email Address (required):* Street Address (required):* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Daytime Telephone (required):*Evening Telephone:Employer:Type of dwelling?Single family residenceApartmentDuplexTownhomeCondoLoftOtherType of dwelling (Apartment, single family residence, duplex, townhome, condo, loft, etc?)Do you:OwnRentIf you rent: Does your lease allow pets?YesNoLandlord's Name:Landlord's Phone:Does your landlord require a security deposit?YesNo(proof of payment required before the adoption can be completed)Length of time at current residence?If less than one year at current residence, please provide previous address:Length of time at previous residence?1 to 3 years3 to 5 years5 or more yearsDo you have a fenced yard?YesNoType of Fence?Height of Fence?Will you use a fenced run/pen?YesNoWill you use a tie out?YesNoOccupation - Do you:WorkWork at homeStay at homeRetiredAttend schoolNumber of adults in the home:Number of children in the home and ages:If multiple adults in the home, do both adults work outside the home?YesNoDoes everyone in household agree to getting a new pet?YesNoHow many hours per/day will your pet be left alone?Where will your pet stay when you are not home?Where will your pet stay during the day?Where will your pet stay at night?Do you currently have any pets? (required)*YesNoIf yes, please give names, breeds and ages, as well as any other relevant information about the pet: (Type N/A if not applicable.)If you have current pets, are they spayed/neutered? (required)*YesNoNo current petsIf you have current pets, are they up to date on shots?YesNoIf you have current pets, are they on heartworm and flea preventative?YesNoWhat type of heartworm medicine do you use?What type of flea preventative do you use?What type of food do you feed your pets?If not on heartworm and flea preventative, please explain as it is a requirement for approved adoption applications: (Type N/A if not applicable.)If you don’t currently own a pet, have you owned one in the past? (required)*YesNoIf yes, please explain why the pet is no longer with you: (Type N/A if not applicable.)Have you ever surrendered a pet to a shelter or animal control? (required)*YesNoWill the pet be:IndoorOutdoorBoth indoor and outdoorIf both indoor and outdoor, how much time will the pet spend indoor and outdoor?Why do you wish to adopt this type of animal?CompanionAs a gift for someoneFor a childCompanion for other petPersonal protectionWatchdogIf you are adopting a cat/kitten are you planning to have it declawed?YesNoIf you are adopting a cat/kitten are you planning to let it go outside?YesNoHow would you describe your household? Busy Quiet Away from home a lot Travel often Active Other If you described your household as other above, please explain.Have you ever adopted from us before?YesNoIf yes, name of pet(s), type(s) and date of adoption(s)Name/address/phone # for current veterinarian (To check current pet records) or veterinarian that you plan to use (if you don’t have a current pet) (required)*What will you do with your pet if you move, become ill, or experience a major life change?Realizing that dogs and cats often live 15 years or longer, are you willing to take responsibility for your pet's entire life, keeping it current on yearly shots and tests?YesNoAre you willing to keep your dog on heartworm preventative?YesNoAre you willing to use effective flea control products?YesNoWill you decide to alter your pet's appearance other than normal grooming (declaw, dock tail, crop ears)?YesNoHow do you feel about spaying/neutering?Are you prepared to make a lifestyle adjustment to provide this animal a forever home?YesNoUnder what circumstances do you think it would be wise to find a new home for a pet?Are you aware that Pup & Cat Co charges a $300.00 adoption fee?YesNoHow much does it cost to care for a pet per month?Are you willing to deal with an adjustment period and to work through behavioral problems? If no, please explain.Are you willing to take your pet to obedience training?YesNoWould you be willing for a representative of our organization to do a home visit before and after adoption?YesNoWould you be willing to conduct a meet and greet between your current pet(s) and the pet you are interested in adopting?YesNoI do not have any current pets.Would you be interested in any of the following? Select All Making future donations to Pup & Cat Co Volunteering with Pup & Cat Co Becoming a foster family for a dog or cat ********* REQUIRED - APPLICATION TRUTH AND ACCURACY* I agree I certify that the information given on this application is true and correct. If I am approved to adopt an animal, I agree to all the above requirements. I understand that failure to comply with any of the requirements will result in confiscation of adopted animal.****VET CHECKS I agree Please note that we will be making vet checks on all applications that are being considered for adoption. It would be most helpful and save us time if you would let your vet know that they may receive a call to confirm your vet records. Thanks in advance!CAPTCHACommentsThis field is for validation purposes and should be left unchanged.
