Adoption App (Weebly) - PETS WITHOUT PARENTS

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Adoption Application

Please answer each required question. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED! When finished, click the "SUBMIT" button at the bottom of the form.
Please note that submitting an online application for a particular pet does not necessarily mean that pet will be placed on hold for you. A hold is issued on a "first come, first served" basis, and you will be assigned in the order received.
In order for a pet to have the best chance of going home as soon as possible, please come into the shelter to meet the pet you are applying for to be sure it is the right fit for you. We cannot place long term holds on a pet.
Once your application is approved and the pet has been spayed/neutered, you must complete the adoption by the next business day or your hold will be removed. Please understand that the sooner a pet is adopted and goes home, the sooner a cage frees up to save the life of another companion animal in need.

Pet Your Are Interested In

* Indicates required field

Pet's Name *

Type *

Dog Cat

Breed *

Age *

Gender *

Male Female

About The Applicant

First and Last Name *

First

Last

Email *

Primary Phone *

Secondary Phone (Optional) *

Address *

City *

State *

Zip *

County *

Employment/Student

Employed? *

Yes No

Employer *

Occupation *

Student? *

Yes No

References (Only one may be a relative)

First and Last Name (Reference 1) *

First

Last

First and Last Name (Reference 2) *

First

Last

Phone *

Phone *

Relationship *

Relationship *

Housing Detail

Type of Housing *

Do you Rent or Own? *

Rent Own

If housing is "Other," please note here. *

If you rent, please provide landlord's contact information below.

Landlord's First and Last Name *

First

Last

[object Object]

Landlord's Phone *

Number of adults in the home *

Number of children in the home and ages *

Has anyone in the home been convicted or charged of a crime related to violence? *

Yes No

Experience with Pets Without Parents

Have you ever filled out an adoption application with Pets Without Parents? *

Yes No

If "Yes," when did you fill one out? *

How did you find out about Pets Without Parents? *

Have you ever adopted from Pets Without Parents? *

Yes No

If "Yes," when did you adopt? *

Who did you adopt? *

History of Pet Ownership

Current Pets in Home

Name (Pet 1) *

Breed *

Age *

Type *

Dog Cat

Spayed or Neutered? *

Yes No

Current on Vaccinations? *

Yes No

How long have you owned this pet? *

Name (Pet 2) *

Breed *

Age *

Type *

Dog Cat

Spayed or Neutered? *

Yes No

Current on Vaccinations? *

Yes No

How long have you owned this pet? *

Name (Pet 3) *

Breed *

Age *

Type *

Dog Cat

Spayed or Neutered? *

Yes No

Current on Vaccinations? *

Yes No

If you have additional pets, please provide details for each in the designated section at the end of the application.

Pets You Have Owned In The Last Five Years (Not including current pets)

Name (Pet 1) *

Name (Pet 2) *

Name (Pet 3) *

When and why did this relationship end? *

When and why did this relationship end? *

When and why did this relationship end? *

Type *

Dog Cat

Type *

Dog Cat

Type *

Dog Cat

If you've had additional pets, please provide details for each in the designated section at the end of the application.

Why would you NOT keep a pet? (Check all that apply) *

Allergies Moving Marriage Divorce Too expensive New baby Illness of pet Illness in Family Gets too big New job Animal's Behavior Not getting along with current pets Lack of knowledge Not enough time I would never give up on a pet Other

Have you ever given up a pet? *

Yes No

If "Yes," what were the circumstances? *

Veterinary Information

Current or Previous Veterinarian *

Phone *

If you've used a previous vet, or your pet records are under a different name than yours (spouse, parent, etc), please provide that information in the field below.

Additional Veterinary Information *

Care of Your New Pet

Why do you want a pet? (Select all that apply) *

Companion/Family Member Gift Watch Dog To Breed Mouser Child's Pet Friend for Other Pet Other

If "Other," please provide details. *

Do you intend to breed this pet? *

Yes No

Do you have a fenced yard? *

Yes No

Do you own a crate? *

Yes No

Where will your pet stay during the day? *

Where will your new pet sleep at night? *

How long will your new pet be alone during the day (# hours)? *

Per year, how much do you expect veterinary costs to be? *

Can you/will you afford an average of $500 in vet expenses should this pet become ill? *

Yes No

Do you anticipate any major changes in the next year (moving, new baby, etc.)? *

Yes No

If "Yes," please provide details. *

Your new pet could live for another 20 years. Do you understand the responsibility involved, and are you willing to make a lifelong commitment to this pet? *

Yes No

If Adopting a Cat

How will you prevent your new cat from scratching furniture, etc? *

Do you intend to declaw your cat? *

Yes No

Will you let your new cat outside, and under what circumstances? *

If Adopting a Dog

How will you deal with behavioral issues that may arise with your new dog? *

Do you expect your new dog to have accidents in the house, even if it's housebroken? *

Yes No

Additional Information

Provide any additional pet details or other information that you think would help us process your application. *

Affirmation

Pets Without Parents, Columbus relies on the information given above to be complete and accurate in order to act on your application in a timely manner. Any false statements, misrepresentations, inaccurate information, or failure to supply the data requested may serve as a rejection of your application. By selecting "I Agree", you are authorizing the use of any screening agencies to verify criminal history and vaildate the accuracy of all information recorded above, and you give Pets Without Parents, Columbus the right to call your references, landlord, and veterinarian. I also understand that this application will not be fully approved until I have come in to meet the pet and been interviewed by Pets Without Parents staff. Pets Without Parents, Columbus reserves the right to reject any application for any reason.

Agree or Disagree? *

I agree I disagree

Date (MM/DD/YYYY) *

Submit

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