Adoption Application

Thank you for your interest in adopting a new member of your family. Our goal is to get pets into responsible, loving, permanent homes. Please fill out the adoption application so that we may find out more about you and your family, so that both you and your dog may find the right fit. Please Note: We are committed to matching the right dog to the right family so all will have many happy years together. Our adoption process includes the completion of an application, meet and greet, home visit, veterinary reference, adoption fee and contract. Our adoption fees vary from 100.00 to 400.00 depending on medicals and different circumstances of the pet and type of pet since we are an all animal, all breed rescue. We are a 501c3 organization and the adoption fee is 100 % tax deductible which includes all vaccinations, spay/neuter, Heartworm test, deworming and microchip.
Is there a particular pet or breed you are interested in? If so, please name.
Name
First Last
Address
Street Address City State ZIP Code
Email
Home Phone
Cell Phone
FL Driver's License # or Valid I.D. #
Employer Name
Employer Address
Street Address City State ZIP Code
Length of Employment
Are You a Full Time or Seasonal Florida Resident?
- Full Time
- Seasonal
Type of Housing
Do You Own or Rent?*
- Rent
- Own
Does Your Landlord or Association Allow Pets?*
- Yes
- No
Landlord Name
First Last
Landlord Phone
Weight Limit for Dogs, if any
Is a Pet Deposit Required?
- Yes
- No
Amount of Deposit:
Do You Have a Fenced in Yard?
- Yes
- No
Do You Have a Pool?
- Yes
- No
Do You Plan on Moving in the Next 6 Months?
- Yes
- No
If You Move, What Will You Do With Your Pet(s)?
Do You or Does Anyone in Your Household Have Allergies or Asthma?
- Yes
- No
Are You Adopting This Pet for Yourself or Someone Else?
- Myself
- Someone Else
What Member of the Family Will Be Taking the MAJOR Responsibility of Caring for This Pet?
List the Names, Relationship, & Ages of Members of Your Household. (Include Yourself)
Name Age
Have You Ever Had a Cat or Dog?
- Yes
- No
List All the Animals You Currently Have
Name Type of Animal Age Sex Spay/Neutered? Shots Current?
List Any Animals You Have Previously Had That Are No Longer With You
Cat or Dog? Name Age Reason No Longer With You
Present Veterinarian Name
First Last
Veterinarian Address
Street Address City State ZIP Code
Veterinarian Phone
Have You Ever Turned in an Animal to a Shelter?
- Yes
- No
Why Did You Turn the Animal In?
Have You Ever Put a Dog to Sleep for Any Reason?
- Yes
- No
Why Did You Put the Dog to Sleep?
Is Anyone Home During the Day?
- Yes
- No
Who?
Have You Considered Adopting Two Similar Pets to Keep Each Other Company?
- Yes
- No
Where Do You Plan on Keeping Your Pet While You are at Work or Not at Home?
What Will You Do if Your New Pet Doesn't Get Along With Your Current Pet(s)?
How Long Will You Give Your New Dog to Adjust to it's New Home?
If Your Family Status Changed (new baby, married, divorced, job loss, relocation) Who Would Keep the Dog?
If something Happens to You (sickness, death, etc. ) and You Cannot Take Care of Your Pet(s), Who Will Take Care of Them?
When You Go on Vacation, Where Will Your Pet(s) Go, and Who Will Take Care of Them?
What Do You Think Are the Most Important Responsibilities of Owning a Pet?
Please Supply the Name, Address, and Phone Number of Two Personal References (non-relatives).
Name Address Phone
Add Any Additional Information You Feel is Important
I certify that the information I have given above is true and correct, and I hereby authorize the above listed Veterinarian(s) to supply information in regard to my I also give my permission to contact the above listed landlord and references.*
- I agree.
Applicant Signature*
Application Date
Approved By
Approval Date
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Name	Age

Name	Type of Animal	Age	Sex	Spay/Neutered?	Shots Current?

Cat or Dog?	Name	Age	Reason No Longer With You

Name	Address	Phone