Adoption Application « giwishes.org

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Application for Adoption

Name:
Pet’s Name:
Sex: Male
Female
Address:
Breed/Description:
City/State:
Zip:
Foster:
Are you a Veteran? yes
no
Applicant’s Email:
Applicant’s Home#:
Cell#:
Pet History
Please list your present/past pets, most recent first.
Pet’s Name:
Current Pet? yes
no
Breed:
Age:
Spayed/Neutered? yes
no
If not current pet, what happened and when?
Pet’s Name
Current Pet? yes
no
Breed:
Age:
Spayed/Neutered? yes
no
If not current pet, what happened and when?
Pet’s Name:
Current Pet? yes
no
Breed
Age
Spayed/Neutered? yes
no
If not current pet, what happened and when?
List ALL Veterinarians/Clinics used for the animals listed above:
Name:
Phone:
Name:
Phone:
Name:
Phone:
Human Name records are under:
I would like to adopt this animal for:
  Companion
  a Gift
  to Breed
  a Watch Dog
  For My Children
  Other
If other, explain;
Environment
Number of adults in household?
Ages:
Number of children in household?
Ages:
Who will care for this pet when you are out of town:
Do you live in a:
Do you own or rent?
If you rent, may we contact your landlord?
Deposit required?
Landlord Name and phone number:
How long at your address?
Do you have a fenced yard? yes
no
Type and Height:
Do you own a pick-up truck? yes
no
If yes, will the pet ride in the back? yes
no
Do you own a swimming pool?
Do you own a swimming pool? yes
no
Is it secured yes
no
Will the animal have access to it? yes
no
Average time this pet will be alone:
During the day. I will keep the pet in the:
When left alone, I will keep my pet
Durrng the night, the pet will sleep in the
If other, please describe:
Beyond basic food, how much are you willing to spend for vet care and other expenses per Year?
Have you ever surrendered a pet to the shelter (pound)? yes
no
If yes, please explain:
References
Please list two (2) References (NOT RELATED) who are familiar with you and
your relationship with animals.
Name:
Phone:
Name:
Phone:
Where did you hear about G. I Wishes?
Have you ever adopted a Rescue Animal before? yes
no
If yes, when?
By checking the box below I authorize the veterinarians listed above to release any information requested by G.l. Wishes deemed necessary to process the application.
I Agree *
Full Name:
Date:

Terms

1. I will provide this animal with proper food,fresh water and adequate shelter at all times. I will provide a safe, locked and, fenced area for the animal to exercise in. I agree to never chain the animal for containment. I will care for the animal both physically and mentally in a humane manner, giving the animal ample time to adjust to its new home.
2. I will provide veterinary treatment for thisa animal whenn needed, including annual Rabies,Distemper/Parvo, Canine or Feline vaccinations including heartworm preventative medication and necessary dental health procedures