Are You Adopting for Yourself Or Someone Else?

ADOPTIONAPPLICATION

Tobeconsidered asanadopter,youmust:

Be21years ofageorolder

Haveidentificationshowingyour presentaddress

Havetheknowledge andconsentofyour landlord

Beableandwillingtospendthetimeandmoneynecessarytoprovidemedicaltreatmentandpropercareforyourpet(s).

Applicant Information

Date

First Name / MI / Last Name
Street Address / Apt/Unit #
City / State / Zip
Home Phone / Cell Phone
Email / Age

**NewLeash onLifereservestherighttorefuse adoptiontoanyone.
Noanimalwillbeadoptedto prospectiveownerswhomisleadorfailtoprovide
accurateinformationonthis application.**

Are you adopting for yourself or someone else?

Which animal are you interested in?

Cat

Dog

Name:

What kind and how many pets do you currently have?

Current pets’ names and ages.

Are your current pets spayed or neutered?

Yes

Are your pets current on vaccinations?

Yes

If you currently do not have any pets, have you had any in the past?

How long ago has it been since you’ve had a dog or cat?

Have you ever turned one of your animals into a shelter?

Yes

If yes, please explain.

How many adults are in your family?

Children?

Children’s Ages

Where do you live?

House

Apartment

Condo

Mobile Home

Other

Do you own or rent your home?

Own

Rent

How long have you lived at this address?

Please provide your landlord information below if you rent. We will contact them to verify that you have permission to have a pet in your home.

Landlord Name

Phone number

If you go away for vacation, who will take care of your pet(s)?

What arrangements will you make for the care of your pet(s) in case of an emergency or if you become unable to care for him or her?

If you must move, what will you do with your pet(s) if your new home does not allow pets?

CatAdoptions Only
Have your current cats been tested for feline leukemia and FIV? / Yes / No / Don’t Know
Under what circumstances would you have the cat declawed?
Where will your cat live? / Indoors / Outdoors / Free access to indoors & outdoors / Barn
Please explain.
Does any member of your household have an allergy to cats? / Yes / No
DogAdoptions Only
How long will the dog be alone each day?
How much exercise and socialization will the dog receive?
Where will the dog sleep?
Is there a safe, fenced area for the dog to out to use the bathroom or will you walk your dog?
Under what circumstances do you consider it acceptable to crate a dog?
When do you consider it acceptable to physically punish or hit a dog?
Under what circumstances is it acceptable to leave a dog outside?
Do you realize you will probably have to house-train your new puppy or dog? / Yes / No
Veterinarian References
Veterinarian Name (current or past)
Address:
Phone
Two Personal References
Name
Address
Phone(s) / Email
Name
Address
Phone(s) / Email

Icertifythatmyanswersaretrueandcomplete.Incompleteapplicationswillnotbeapproved.

Signature: Date: