Adoption Application and Contract

 

Please fill in the information in all fields to complete this application:

 

Name
Address
Email Address
Home Phone Work Phone
Cell Phone Fax Number

 

1. Who is the pet for?   Age of Adopter
   
2. What is your familiar status?
    If you are single, do you Do you Work? No         Yes

    If you are married, do you both work?    No          Yes
    Your Work Hours: Your Spouse's Hours:
    How many children do you have at home? Children's Ages
    Do children regularly visit your home?     No          Yes
    Who will be responsible for the pet? 
   
3. Residence Information: Do you,
    Type of Dwelling:  House  Apartment, if so: Floor No. Elevator No  Yes
    If renting, does your lease allow pets?     No         Yes       Don't Know
    Do you have a yard? No     Yes Is it fenced? No      Yes
    If fenced, what type of fencing do you have?
    Do you have a crate? No     Yes Have you ever crate-trained? No    Yes
    Are you planning a move? No    Yes  
    Does anyone in your residence have allergies to pets?    No             Yes
    Where will your pet be kept?      Daytime:        Evening:
   
4. Pets:      Do you have other pets now?     No        Yes
    If yes, Please fill out the table below with the information about your other pets:
Type Age Ownership Length Where they are kept Spayed/Neutered (Yes or No)
    Have you had pets in the past?         No             Yes
    How long has it been since you had a pet?
    What happened to the pets?
   
5. Miscellaneous Information:  
    Your occupation?
    Your Employer?
    Spouse's occupation:
    Spouse's Employer:
    Do you currently have a veterinarian?         No             Yes
    If Yes, Vet's Name:           Phone:
    Address:
Are you aware that the annual routine vet expenses range between $75-$350?
Are you aware that pets need monthly heartworm and Flea & Tick preventatives?

 

 

I acknowledge that all of the information on this application is true and correct.  I understand that any misrepresentation of fact may result in my not being approved to adopt a dog or the removal of the adopted dog from my home by ADRATI.

 

Applicant(s) understands and agrees that visiting dogs for potential adoption is at their own risk.  Applicant(s) agrees to hold harmless, release and indemnify ADRATI and its officers and directors from any and all claims that may arise as a result of the application and/or the application process to adopt a dog from ADRATI.  Applicant(s) signatures below indicates agreement.

 

While ADRATI makes every attempt to meet the medical needs of rescue animals, no guarantee is made of the health of any animal.

 

Angel Dogs Rescue And Transport, Inc. reserves the right to refuse or deny any application.

 

1. The adopter agrees to pay a non-refundable adoption fee.
2. The adopter agrees to provide care and treatment for the companion animal to insure its well being, including but not limited to:  Dry, clean living quarters with protection from weather; fresh, clean water and food shall be provided daily; medical care as required and all necessary vaccinations; licensing by any state or local laws; the animal will not be restricted to outdoors; the adopter will provide love, care, and attention to their companion animal.
3. The adopter will insure that the companion animal will not be chained, tied, or caged and will be free from inhumane acts on the body not limited to striking, punching, maiming, mutilating, or applying caustic substances and will not be used for medical or other research or experimental procedures, religious rituals, or illegal activities.

 

 

Application Submitted For Dog Named:

 

Adopter Name:

 

Signature:     I Agree to the Terms Above                 I Disagree

 

Date:

 

 

 

Hosted by WebMax, LLC

Visit us at www.WebMaxHosting.com

For questions or comments about this web site contact the webmaster at info@webmaxhosting.com.
Copyright © 2006-2011 Adrati.
Last modified: 06/16/2011