Make a difference.Thank you for considering adopting a rescue animal. Please fill out the form below to begin the adoption process. Personal Information Name of Dog/Cat you are Interested in: * Primary Adopter * First Name Last Name Email * Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Employer * Age * Driver's License Number * Household Information Are all members of your household in agreement with this adoption? * Yes No Unsure Who will be the pet's primary caregiver? * First Name Last Name Have you or any household members ever been accused or convicted of animal, cruelty, and/or neglect. * Yes No If yes, please explain below. Do you live in: * House Apartment Mobile Home Townhome/Condo Do you: * Own Rent If rent, please provide the name and phone number of landlord. Are there any breed/size restrictions from your landlord or subdivision? * Yes No If yes, please provide details. i.e., number of pets, size/weight, breed, etc. If renting, can proof of pet deposit be obtained from your landlord? Yes No Do you have a fully fenced yard? * Yes No If yes, height and type of fence. Do you have any of the following? Underground fence Kennel Dog run How many adults are in your household? * How many children are in your household? * If children, what are their ages? Does anyone in your household have dog/cat allergies? * Yes No Have your children been around animals before? Yes No Current/Previous Pet Information List any pets you own or have owned in the past five years and their ages. How many of these pets are spayed/neutered? Where are these animals now? Will you be able to provide proof that all current pets are up-to-date on vaccinations? Yes No Have any pets in your home, past or present, been diagnosed with an infectious disease (FIV, Heartworms, Distemper, Parvo, etc)? If yes, please explain. Have you adopted from an animal welfare group before? Yes No Have you adopted from an animal welfare group before? Yes No If yes, what group? Have you ever given up a pet? * Yes No If yes, what were the circumstances? New Pet Information What typeof personality do you want your pet to have? i.e., calm, energetic, protective, couch-potato Do you have experience with crate training? * Yes No Have you ever housebroken a dog or puppy before? * Yes No How many hours each day will your new pet be home alone? * Where will your new pet sleep at night? * How will your new pet get daily exercise? * Where will your new pet stay when nobody is home? * How will you supervise the dog's outdoor activity? * What length of time will you allow your new pet to adjust to his/her new home? * Are you willing to work through your new pet's issues, if any? * Yes No Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior? * Yes No Do you understand that a dog can be an 18 year commitment, and can cost $300 - $500 per year to care for? * Yes No Are you aware that a large breed dog takes about two years to mature? Is this something you're prepared for? * Yes No Do you plan to take an obedience class with your dog? * Yes No Unsure If yes, where? What circumstances would lead you to give up your new dog? * If you had to give up your dog, what would you do with him/her? * Rescue Animal Preference Type of Animal Dog Cat Other Age Preference Puppy/Kitten Adult Senior Experience with Pets Experienced First-time Owner Veterinarian Information Please provide the name and contact information of your current or previous veterinarian. Veterinarian's Name First Name Last Name Veterinarian's Phone Number (###) ### #### Home Visit Are you willing to have a representative visit your home if requested before the adoption is finalized? Willingness for Home Visit Yes No Additional Comments How did you hear about us? Facebook Pet Finder Adoptapet.com Family/Friend Ninja Paws Animal Advocates North Texas Other References Please provide the below information for two references (non-family). Reference #1 Full Name First Name Last Name Reference #1 Phone Number (###) ### #### Reference #2 Full Name First Name Last Name Reference #2 Phone Number (###) ### #### Terms and Conditions * I have read the above information carefully and have provided answers honestly. I understand that omission of information and/or failure or refusal to answer all questions and sign therein may result in this application being declined. If an omission or untruth is discovered after an animal is placed in my care, Sasha's Pals reserves the right to anullify the adoption and reclaim the animal. I give Sasha's Pals permission to fully investigate the information provided and contact any and all references listed here in. If the application passes review, I agree to possible home visit on a mutually agreed-upon date between myself and a Sasha's Pals representative before a final decision is made. Thank you! Sign up with your email address to receive news and updates. Email Address Sign Up Thank you!
