Online Adoption Application

Please complete the following application to help guide our conversation today.

Please note: We welcome adopters who rent. However, some landlords and management companies have size and breed restrictions, limits on pets, and/or require pet deposits or additional fees. It is your responsibility to verify pet allowance with your landlord.

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Adopter Information

Your name: *

Daytime Phone: *

Date of Birth: *

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Street Address: *

City: *

State: *

Postcode: *

Email Address: *

Emergency Contact Name: *

Emergency Contact Phone Number: *

Tell Us What You Are Looking For

Type: *

Dog

Cat

Other

Size: *

Small

Medium

Large

X-Large

Activity Level: *

Chill

Active

Age: *

Baby

Young

Adult

Senior

Are there any particular animals that you are interested in?
Animal Name:	Animal ID#:
Animal Name:	Animal ID#:
Animal Name:	Animal ID#:
Animal Name:	Animal ID#:

About Your Home

Tell us a little about the members of your family (i.e. # of adults, seniors, young children etc.) *

Tell us about the other pets in your home:

We have one or more dog(s)

We have one or more cat(s)

We have one or more small animal(s)

I would like to introduce a new dog to my dog(s):

Yes

No

Please note: Introductions by staff members will require verification of current rabies vaccinations of your dog(s).

Affirmation and Certification

By typing my name in the Applicant Signature line: I certify that I have read the above application and that all information entered on this application is true and accurate.

Signature: *

Your Signature must match the name listed in the Adopter Information.

Signature Date: *

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