This adoption application is for ONE species only. If you are interested in more than one different species, please complete separate applications for each.
Name of other adult(s) in household:
- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Mobile Phone: Your age?
Number of children living in home (part or full-time):
- 0 1 2 3 4 5 6 7 8 9 10
Names and Ages of Children, if Applicable
List any herp societies or online groups about reptiles you participate in on a regular basis. Is everyone in your household comfortable with the adoption of this animal?
Who would be responsible for the care of the pet? Have you ever adopted an animal before? Have you ever given up, sold, or otherwise relinquished ownership of a pet?
If you have relinquished a pet, please explain why.
Please list two personal references and their relationship to you. These should be people who can attest to your general ability to care for the species you wish to adopt.:
Reference Phone #:
Reference Name 2:
Reference Relationship 2:
Reference Phone 2:
Type of dwelling:
If other, what type?
Own or rent
If not a homeowner, do you have the landlord’s permission to have a pet?
Phone: Are you planning on moving in the next 12 months?
List Your Current Pets Type of pets you currently own How many pets of each type do you have?
What happened to previously owned pets?
Name of the Reptile/Exotic Vet you intend to use for this new pet: Reptile/Exotic Vet Phone: Please list the types of reptiles or amphibians you have significant experience caring for. Significant would be daily care for at least 6 months.
Which ONE species of pet do you want to adopt? If there is a particular animal you wish to adopt, list it here: What books, websites, or materials have you read about this species? Tell us what you know about caring for this species. Please be specific. Which of these items would you need for this species? Check all that apply. What type/size of caging does this animal need at its present size? What type and size of caging will this animal need in 5 years? If this species is carnivorous, which types of prey will you use?
Under what circumstances would you not keep the pet?
If other reason, why?
When you travel, who will care for the pet while you are gone?
If the pet becomes ill or injured, are you financially prepared to provide the medical care?
What are your plans for breeding this animal?
The pet may live 15+ years, what would you do with your pet if you could no longer care for the pet?
Accidents happen. What will you do in event that this animal escapes from its caging? What provisions will you make to assure this animal is cared for if you or the primary caregiver passes away or is unable to care for it?
Is there anything else you would like to tell us about yourself?
If you have ever been charged with the neglect or abuse of an animal or other person, please explain the circumstances: