Georgia SPCA Animal Adoption Application

Please fill out the following application in its entirety. Please note: We do not give refunds for adoption fees.

Georgia SPCA reserves the right to refuse adoption to anyone. You must be 21 years of age or older to adopt.

Section 1: General Information

Name: ______Place of Employment: ______Since: ______

Current Address ______City ______State ______Zip ______

Drivers License State & Number______

Email Address______Phone ______

Name of Spouse/Significant Other: ______Phone ______

Are you 21 years of age or older? Yes No

Have you adopted from the Georgia SPCA before? Yes No If yes, where is the pet now?

Please answer questions below about your current home environment and pet information.

1. Do you live in a House Apartment Townhouse Trailer Other ______

2. Do you own or rent? ______If you rent do you have your landlords/parents permission to have pets. Yes No

Landlords/Parents Name ______Phone ______

STAFF INITIALS______

3. Are you in the process of moving, or anticipate moving in the next few months? Yes No

4. If you ever move have you considered that another place may not allow pets? Yes No

What will you do if they do not allow pets? ______

5. Do you have a fenced in yard? Yes No

6. Number of adults living at home. ______Number of children living at home. ______Ages ______

7. Has everyone in the home met and agreed to this animal? Yes No STAFF INITIALS______

8. If you are planning on having children in the future, have you considered how this animal will then fit into your family? Yes No

9. Does anyone in the family have allergies to cats or dogs? Yes No

If yes, have they consulted a doctor about getting a pet? Yes No If yes, are they taking medication? Yes No

10 .How would you describe your knowledge of cats/dogs? ______

______

______

______

11. Please list current pets***:

Name / Species / Age / Years Owned / Sex / Spayed/Neutered / Where is your pet kept?
Male Female / Yes No / Inside Outside Both
Male Female / Yes No / Inside Outside Both
Male Female / Yes No / Inside Outside Both

***IF YOU HAVE OTHER PETS, ARE YOU WILLING TO PROVIDE UP TO DATE VACCINATION RECORDS IF REQUESTED? Yes No

12. Have any of your pets displayed aggression toward another animal? Yes No
13. Do you have a veterinarian? Yes No Veterinarian’s Name ______Phone______

STAFF INITIALS:______

14. Are you willing and able to make a commitment to routine vet/health care, including monthly heartworm and flea preventative and any other health care your animal may need? Yes No

15. Why are you interested in adopting? Companion For Self Companion For Other Pet Family Pet Gift

16. Would you object to an authorized Georgia SPCA representative inspecting the premises where the animal will be kept both before and after the adoption? Yes No

Section II: Adoption Questions Related to Dogs and Puppies

17. Who will primarily care for this dog (feeding, walking, playing, training, etc.) ______

18. How long will your dog be alone during the day? ______During the week? ______Weekend? ______

19. Where will your dog stay when you are not at home?

Loose In The House Tied Outside Garage Loose Outside Crate Kennel/Run Bathroom Other ______

20. Where will your dog stay during the night?

Crate In House Loose In House Tied Outside Garage Bathroom Other ______

21. Where will your dog stay during vacations and holidays? Pet Sitter Boarding Facility Other ______

22. How will you exercise your dog? Run in fenced in yard Run in unfenced yard Walking Dog Park Doggy Daycare

Cable or Tie Outside Other______

23. Do you understand that puppies are a great deal of work? Yes No

24. Do you understand that they require constant supervision, frequent bathroom breaks (even during the night)? Yes No

25. Do you understand they will chew on things and will also bite? Yes No

26.Do you understand that dogs will require an adjustment period in a new home? Yes No

27. Are you willing to take the time to correctly house break a dog? Yes No

28. Do you understand that changing an animal’s home environment may cause the animal to have accidents? Yes No

29. Do you believe in crate training a dog? Yes No Explain:______

30. If applying for a dog or puppy that is not house trained, how will you house train the animal? ______

31. Which of the following problems would you be willing to work on? Please circle all that apply.

Separation Anxiety Excitability Mild Aggression Obedience House Training Destructiveness Barking

I am not willing to work on Problems/I need more information to decide

32. For which of the following reasons would you ever consider giving up your dog? Please circle all that apply.

Moving Excessive Barking New Baby Not Housebroken Gets Too Large Jumps Fence Claws Furniture

Fighting With Other Pets Medical Issues Allergies Divorce Kids No Longer Want Kids Move Out Financial Problems

Behavior Issues Not Enough Time

Section III: Adoption Questions Related to Kittens and Cats

17. Are you planning to declaw the cat? Yes No

18. Do you know about ways to keep cats from clawing, scratching, etc? YES NO STAFF INITIALS______

19. Who will primarily care for this cat (feeding, walking, playing, training, etc.) ______

20. How long will your cat be alone during the day? ______During the week? ______Weekend? ______

21. Where will your cat stay when you are not at home?

Loose In The House Tied Outside Garage Loose Outside Crate Kennel/Run Bathroom Other ______

22. Where will your cat stay during the night?

Crate In House Loose In House Tied Outside Garage Bathroom Other ______

23. Where will your cat stay during vacations and holidays? Pet Sitter Boarding Facility Other ______

24. How will you exercise your pet? ______

25. Do you understand that kittens require a large amount of supervision when introduced to the home? Yes No

26. Do you understand they will chew on things and will also bite? Yes No

27.Do you understand that pets will require an adjustment period in a new home? Yes No

28. Do you understand that changing an animal’s home environment may cause the animal to have accidents? Yes No

29. Which of the following problems would you be willing to work on? Please circle all that apply.

Separation Anxiety Excitability Mild Aggression Obedience House Training Destructiveness Barking

I am not willing to work on Problems/I need more information to decide

30. For which of the following reasons would you ever consider giving up your cat? Please circle all that apply.

Moving New Baby Not Housebroken Size Jumps Fence Claws Furniture Fighting With Pets Medical Issues Allergies Divorce Kids No Longer Want Kids Move Out Financial Problems Behavior Issues Not Enough Time

Section IV: Legal

I understand that it is my responsibility to see and evaluate the dog for myself before agreeing to adoption. This dog will reside in my home as a companion. I will provide him/her with adequate food, water, shelter, training, affection, exercise, and medical care. All of the information I have given above is true and complete. I am in full agreement with the Georgia SPCA terms of adoption. The Georgia SPCA is in no way liable or responsible for any damage, accident or injury resulting from the placement of a dog or cat into my household.

Applicant’s Signature ______Printed Name ______Date______