ADOPT-A-RESCUED-PET, INC ADOPTION
APPLICATION
Not every pet will fit into your lifestyle. Our
adoption counselors will ask you many questions to determine which pet will do
well in your home and which will not. This way we can be sure the pet you get will
be the pet you want, to love for its lifetime!
Please, understand that we deal with homeless or unwanted
animals. Many of our animals come from unknown backgrounds. The adoption
process may seem time consuming, but we wish to maximize an animal's chance for
a successful, permanent adoption.
Adopting a companion pet is a major consideration and responsible pet
ownership demands a considerable commitment. Thank you for your interest in our fostered animals.
Street
Address _____________________________________________ City
______________________ zip__________
Daytime
phone # ____________________ Evening phone
______________________email_______________________
How
long at this address _____________ If less than 3yr, previous address________________
Own
home?________ Rent?_____(A
statement from the landlord, with address, and phone number is required.)
Does
anyone in your household have allergies to dogs or cats?
___________________________
Children
in the family? _______ How many & what ages?
_______________________________
Occupation?______________________ Place of employment_______________________________________________
Employer’s phone #________________________________________________________________________________
Would
you consent to a pre-adoption and post-adoption home visit? _________
What
pets have you owned before?
___________________________________________________________________
What
happened to
them?____________________________________________________________________________
What
animals do you own now? ___________________________________________________
Spayed
/ neutered? _________________________Do your pets tolerate other animals?__________________________
Your
veterinarian office?
____________________________________________________________________________
Are
you financially prepared to provide the necessary care for your pet including:
proper food, vaccinations, parasite control (fleas, ticks, worms, etc.),
licensing, adequate shelter, and veterinary care for yearly check-ups, or an
after-hours medical emergency or illness,
which could cost $500 or more ?
_____________________________________________
Will
your pet spend all or most of the
daytime indoors? __________________
night ? ___________
Are
you willing to COMMIT yourself and your energies to this pet for its lifetime? ____________
What
do you consider a good reason to give up your pet?
_______________________________
FOR DOGS: Have you ever used a
crate to train a pet? _________
Any objection to doing so if needed, i.e. to prevent unwanted behavior [chewing electric cords,
furniture]; or health problems that might occur; for further house breaking of
a shelter pet; to medicate urinary tract infection, etc.) _________________
Is
your yard fenced “dog secure” ?_________ If not, how will you “potty” your
dog?_____________________________
Will
outside shelter be needed/available while you are away for short periods?
________________________________
Have
you trained a dog in basic obedience in the past?
_________________________________
If
needed for better control, would you be willing to take your dog through a
basic obedience class? _________
I am
interested in the following type, breed, age, size, and animal
_________________________________________
About how many daytime hours, per day, will you be able to be at home with your pet? _________________________
___________________________
________________________
___________
(ADOPTER
SIGNATURE)
(FOSTER WITNESS)
(DATE)
Street ______________________________ City
___________________ Zip __________
Pet Name ___________________ Rabies# _______________
Shelter ID# _____________
Breed or description
________________________________________________________
I affirm that all application information is true. I realize that this is a lifetime commitment to this animal and I will endeavor to give this pet a happy & healthy home. IF THERE ARE PROBLEMS WITH THIS PET, I WILL IMMEDIATELY CONTACT MY ADOPTER FOR ASSISTANCE, OR IF I MUST EVER GIVE IT UP, I WILL RETURN IT TO MY ADOPTER. Initial: __________
FOLLOW-UP AGREEMENT: I agree to allow Adopt-A-Rescued Pet, Inc. to do a home visit prior to adoption, and as a follow up, if needed, to investigate the premises where the animal is kept, and to reclaim the animal, if in the judgment of Adopt -A- Rescued Pet, Inc, the animal is not being adequately cared for, the terms and conditions of this adoption contract have not been met, or if I have misrepresented any facts to Adopt-A-Rescued Pet, Inc. during the adoption process. Initial: _________
NO WARRANTY OR GUARANTEE: I understand that every effort is made to offer for adoption, only healthy, even-tempered animals. However, animals are only available for observation by Adopt -A- Rescued Pet, Inc. for a short time, and therefore, no guarantees, nor implied / expressed warranties with regard to this animal are made. I understand and agree that it is my responsibility to carefully choose the animal I am adopting and that no guarantees are made regarding the health, temperament, or training of animals for adoption. The animal is adopted “AS IS”. I understand and agree that Adopt -A- Rescued Pet, Inc. shall not be liable, in whole or in part, for any personal injury or property damage caused by this animal, or for any injury or illness of this animal, once possession is assumed by the Adopter. The Adopter, hereby, agrees to assume all liability for the animal’s care and any injury or damage done by the animal. Initial: _______
Adopt -A- Rescued Pet, Inc. does not perform fecal tests on cats or dogs and only a general de-wormer is given. I understand that it is recommended that I have a veterinarian perform a follow-up fecal exam, to see if the animal needs additional de-worming. Initial: ________
Listed below are some services that are recommended, but may NOT be included in the adoption fee: heartworm prevention; de-worming for tapeworms; flea and tick prevention; any additional vaccinations; fecal exam; any additional testing; annual exams and vaccinations. . Initial: ________
Other special notations: ____________________________________________________ Initial: __________
By my signature below, I swear that I have read and understand the terms of this adoption contract, and all of my obligations and responsibilities pertaining to adopting this animal. I enter into this contract of my own free will and agree to all the terms and conditions contained herein.
___________________________
________________________
___________
(ADOPTER
SIGNATURE)
(FOSTER WITNESS)
(DATE)
NOTE: Your donation has helped to save one or more animals from demise. However,
the cost of vet visits, medications, vaccinations, spay/neuter, care, etc,
often exceeds the donations asked. If you would like to increase the donation,
in order that we may save more animals from death, please help others by
adding to your gift.
7-07-04 revised