found a new home!
Plenty of my friends are looking
for one too. Find a pet to adopt.
I am up to date with shots, good with kids, good with dogs, and good with cats.
Zipcode______________ Phone: __________________________________
Email:__________________________________ Can we text you?_____
Name of companion you are interested in adopting with us ____________________
Do YOU HAVE HANDS ON Experience with the breed of pet you are interested in adopting?________
Current companions: Dogs, #___ Cats, #____ Is your cat Declawed_______
Pets Ages_______________________Breeds____________________Other pets______________
Are they Spayed / Neutered?_____ IF NO, Why?________________________________________
Are your pets Indoor__ Outdoor__ Both__ Pet door___ Garage____ kennel___ Other_______
Who is your current Veterinarian___________________________________Phone____________________________
Do you have a vehicle to take this pet to a veterinarian? Yes__ No___
What brand of pet food will you feed this pet as a regular diet____________ Flea Products_______
How many hours each day will this pet be alone______________________________
Companion History: When did you last care for a companion? _______age of pet_____
Were they spayed/neutered ? ____Were they indoor or outdoor?_________
Where is this companion now?_________________________________________
Have you had experience with kittens that scratch when they are young and playing?
If cat jumps on tables or furniture will this bother you? ___ Explain__________________________
Do you and family understand cats may scratch when frightened or constantly handled?
What type or Brand Litter will you use_____________ How often will you scoop the box?________________________________________________________________________________
When you are not home where will this companion be _________________________
Will this cat be indoor____ Outdoor____ Both____ Kept in another room_____ be caged_____
Going Away, vacation, work trips etc.
Will you take companion with you ?___ Have a Petsitter ___Board ____Take to family ,friend, neighbor home_____ Friend ,family, neighbor, name and phone_______________________________________
List everyone living in your home or visiting on a regular basis, weekends etc.
Adults ages __________roommates______ children ages__________ grandchildren ages______________________ _____________________________________________
Are you In a House____ Apartment___ Condo___ Mobile Home___ Hotel___ Temp housing___
Buying __ Renting __ Military Housing__ Living with someone ___ Month to Month ___
If you move, are deployed, have a baby, have a family member move in ,Will you keep this pet?____ Does your Job require traveling or relocating ?_____
If you must give up this companion do you have family who can care for them?______________
If you are unable to care for this pet where will pet go? __________________________________
What would cause you to give up this companion?______________________________________
Applicant Employment _________________________ Phone________________ supervisor________________
Co-Applicant Employment ____________________Phone____________________
REFERENCES, Please list references, Pet sitter, Groomer, Neighbor, Friend, Co worker
1. Name_________________________________ Phone #(____)_________________
2. Name________________________________________ Phone #(____)_________________
By signing below I attest that I have Never been convicted of animal abuse, Animal cruelty,
Neglect or abandonment in the state of Virginia Or any other state or country.
Any untruthful answers or not meeting the requirements for this adoption can result in the forfeiture of the companion adopted by me?
I have read this Form and understand that applying does not ensure approval. Visiting a companion does not ensure Adoption.
Applicant Name Print_______________________________Date_____
Co-Applicant Name print____________________________________Date_______
OFFICE USE ONLY:
Application reveiwed by: ____________________________________Date________