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Your website will not let me fill out an application online had to copy and paste to two different sites. so sorry for the fomat. best i can do.

Date:_11-3-2017____Time:__0629___ Int:_____ Date:_________________ Name of prospective Animal_________koda_________________ Name:___Marsha Barrick_____________________________ Address:___3305 1st ave n________________________________ City:__Great falls_________________________ State:_______mt________ ZIP:___59401___ Home phone:____771-8364_________ Cell__750-1330____ Work____455-5260___________ Are you 18 or Older? __yes_____ Birthdate ___3-2-87___________ DL # __0301819874102__ Thank you for considering adopting from our shelter. You will be making a 10-20 year commitment to the pet you adopt and our goal is to help make the best match possible for you and the pet you are interested in. Before you adopt, please consider the time, effort, and funds ($1,000 annually for food, supplies, vaccinations, and veterinary care) necessary to properly maintain an animal. Consider your residential position and the chance that you may move away, leaving a committed friend behind because you may not be able to bring your pet with you. Responsible pet ownership requires a commitment to provide care and companionship for the life of the animal. Please complete this application in full so that we can help match a pet’s individual needs and personality traits with you. Homeowner __yes___ Renter_____ Other_____ Landlord/ Home Owner Name and Phone Number ____________________________________________________ Yard (Y/N) _y____ Fenced (Y/N) ____y__ Children (Y/N) ___n_____ Allergies (Y/N) ____n_____ Other pets at this address (Y/N)* ___y___ *If yes, please see second page. Seeking: Dog_y_____ Cat ______ Other______ Is this a Gift for Someone(Y/N)? ____y______ First experience with a pet (Y/N)? _n____ I seek a pet that is: (Circle all that Apply) Size: Large Any Size Energy: Outdoorsy Lap Dog/Cat Mellow Affectionate Quiet Reasons for New Pet: Walking buddy Guard Dog Companion for other Pet/ Self Noise/ Activity level in your home: Medium Low Animal will be: Indoor only Pet will be alone____1-2___ hours a day Current Pets at this Address: Pet Name: ____Tessamarie__ Owner’s Last Name: Barrick_____ Check One: Dog _y____ Cat ___ Ferret ____ Veterinarian Clinic: ___Great Falls Veternary Clinic_ (Office Use Only) (Office Use Only) Rabies Expiration Date: ______________________ City License Expiration Date: ______________________ Pet Name: _Zoey Madison______ Owner’s Last Name: __Barrick____ Check One: Dog ___1__ Cat _____ Ferret _____ Veterinarian Clinic: ___________Great Fals veterinary clinic__________________ (Office Use Only) (Office Use Only) Rabies Expiration Date: ______________________ City License Expiration Date: ______________________ Pet Name: __Abbey Lou___________________________ Owner’s Last Name: __Barrick_______________________________ Check One: Dog _____ Cat __1___ Ferret _____ Veterinarian Clinic: __Great Falls Veternary Clinic_ (Office Use Only) (Office Use Only) Rabies Expiration Date: ______________________ City License Expiration Date: ______________________ Pet Name: _____________________________ Owner’s Last Name: _________________________________ Check One: Dog _____ Cat _____ Ferret _____ Veterinarian Clinic: _____________________________ (Office Use Only) (Office Use Only) Rabies Expiration Date: ______________________ City License Expiration Date: ______________________ Pet Name: _____________________________ Owner’s Last Name: _________________________________ Check One: Dog _____ Cat _____ Ferret _____ Veterinarian Clinic: _____________________________ (Office Use Only) (Office Use Only) Rabies Expiration Date: ______________________ City License Expiration Date: ______________________ Pet Name: _____________________________ Owner’s Last Name: _________________________________ Check One: Dog _____ Cat _____ Ferret _____ Veterinarian Clinic: _____________________________ (Office Use Only) (Office Use Only) Rabies Expiration Date: ______________________ City License Expiration Date: ______________________ Pet Name: _____________________________ Owner’s Last Name: _________________________________ Check One: Dog _____ Cat _____ Ferret _____ Veterinarian Clinic: _____________________________ (Office Use Only) (Office Use Only) Rabies Expiration Date: ______________________ City License Expiration Date: ______________________ Pets take a minimum of two weeks to adjust to a new home, and many times even longer. They may have accidents, damage items, hide, become anxious and/or exhibit any number of other undesirable behaviors. Are you prepared to dedicate the time, patience, training and/or financial burden this animal may require? __yes_______ Under what circumstances would you not be able to keep this animal? __aggressive__ What plans do you have in place if you were unable to keep this animal? _If matches well with my dogs even though it is a gift for my dad. Will keep no matter what_ I certify that the above information is true and correct. I also acknowledge that falsification or attempt to mislead the Great Falls Animal Shelter of the above can result in my being denied adoption. I understand that all animals adopted from the Great Falls Animal Shelter must be spayed or neutered before they are released from the Shelter. Applicant Signature____Marsha Barrick_ Date__11-3-2017___ Office Use Only: Landlord/ Homeowner Approval: YES________ NO___________ DATE:______________________ Notes: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Adopt-A-Friend Check: YES________ NO___________ DATE:______________________ Notes: ___________________________________________________________________________ ___________________________________________________________________________ Verified Vaccinations: YES________ Verified City License: YES________ Staff Signature___________________________ Date:_______________ Approve _______ Deny _______ Revised 07/01/16