EmailMe Form - Dream Paws and SNAP of MI Adoption Application

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email

Phone

### - ### - ####

Co-Applicants Name (spouse or other adult living in the house)

First Last

Phone

### - ### - ####

Email

Animal interested in adopting

Type

Dog

Cat

Other

References:

You must have TWO references. Only one may be a family member. In addition, if you currently own or have owned pets, you must provide a veterinarian reference.

First Reference
(only one relative, please)

First Last

Relationship

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Email

Second Reference
(only one relative, please)

First Last

Relationship

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Email

Veterinarian
(Current or one previously used)

First Last

Veterinary Clinic

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Age of pet you want to adopt

Activity level of pet you wish to adopt

Housing-
Rent _______

Own________

FOR RENTERS: Please list your landlord's name, phone number, and email address

Are there restrictions to the number, size, or breed of animal in your home, city, or county?

Number if adults in your home

Number of children in the household and ages

Children who may visit and ages

Does anyone in the family have asthma or allergies to pets

Do you have a fenced-in. yard

If yes, what kind and how high

If no, how would the pet (dog) be exercised/allowed to stretch their legs

Number of current animals

First animal kind

Sex, neutered/spayed, how long have you had this animal

What type of heartworm prevention (dog) is this pet on

How long have you had this animal

Where does this animal sleep

Second animal kind

Sex, spayed/neutered, how long have you had this animal

What type of heartworm prevention (dog) is this pet on

How long have you had this animal

Where does this animal sleep

Do your present animals have health or behavior concerns? If so, please describe

What animals have you had in the last five years and where are they now

How many hours will the pet be alone each day, including drive time

Where will the pet be housed while you are away

Where will the pet be at night

If needed, how do you plan on housebreaking this pet

Who will be the primary caregiver for this pet

If needed, will you take this pet to obedience classes

Who will take care of the pet in an emergency or vacation

What kind of behavior do find unacceptable in a pet

Some pets prefer a crate. Are you willing/prepared to crate this pet

Are all members of the family aware you are applying for this pet

Will all family members be available for the home visit

If not, why

RESCUE AGREEMENT

THIS RESCUE REQUIRES THE RETURN OF THE PET SHOULD YOU FIND YOURSELF IN A SITUATION WHERE THE PET CANNOT BE KEPT. PLEASE INITIAL ABOVE THAT YOU HAVE READ AND AGREE TO THIS STATEMENT

By my signature below:

* I certify that the above information is true and I understand that false information may result in nullifying this application.

* I understand that you will contact my veterinarian for the vaccination and health history for the pets I have and have had.

* I am aware that prior to adopting a pet from Dream Paws and/or SNAP of MI, my currently owned pets must be spayed/neutered and up-to-date on vaccinations.

*I understand that this application is the property of Dream Paws and SNAP of MI and will be retained by them even if I am denied this adoption.

*I understand that the pet will be returned to Dream Paws and SNAP of MI in the event that the pet cannot be kept due to extenuating circumstances.

* I understand that Dream Paws and SNAP of MI may have no prior history on the pets they have up for adoption.

*I acknowledge that I understand and agree to abide by the adoption requirements, including the no-refund policy should the placement fail.

Signature, Date, and Time

Clear