ANIMAL ALLIES
ADOPTION PROGRAM APPLICATION

Our goal is to place animals in our care into permanent, loving homes. We match animals to adoptive families based on mutual suitability. This application will assist us in finding the right pet for your family.
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Please fill this form out as completely as possible.

NOTE: Use the TAB key to move between fields, hit ENTER to submit the form
Pet Name:
Animal Allies Contact Person:
Your Name:
Your Email Address:
Address:
City, State
Home Phone:
Work Phone:   Employer:
List All Family Members:
Spouse's Name:
(Children's Names and ages)
List Other Companion Animals That Reside With Your Family:
Cat or Dog(Breed)NameSexAgeSpayed/Neutered
CatDog MaleFemaleYesNo
CatDog MaleFemaleYesNo
CatDog MaleFemaleYesNo
CatDog MaleFemaleYesNo
CatDog MaleFemaleYesNo
CatDog MaleFemaleYesNo
If your pet has passed away recently, please indicate the circumstances.
Do you own your Home or rent? Own Home Rent
Landlord Name and Telephone #
Have you had any pets in the last five years, and if so, where are they now?
If this application is for a cat, will you declaw?Yes No
Where will your new pet be kept?Indoors Outdoors Both
Is anyone in your household allergic to dogs or cats? Yes No
Where will your dog sleep at night?
Do you have a fenced in yard?Yes No
If not, and you are adopting a dog, where will he/she be exercised?
Are you making a lifetime commitment to this pet?Yes No
Have you ever released a pet to a shelter? Explain?
Under what circumstances would you consider giving up your pet?
Are you willing to seek out professional advice for behavioral problems with your new pet, should they arise?Yes No
How much do you think it will cost to feed this pet per week?$
How much do you think it will cost for medical care per year?$
Are you going to spay/neuter this pet?Yes No
How many hours will your pet be left alone each day
Is anyone going to be home during the day?Yes NoIf Yes, Who?
Veterinarian:
Vet's Phone Number:
Please give a personal reference if no veterinary reference:  Phone:
You can put any special comments here:
By completing this document, you are giving your consent for Animal Allies to contact your veterinarian and above-listed personal references to inquire on the history of previously owned animals and animals currently in your care.
© 2006 Animal Allies