Apply to Adopt

WORKFLOW_EntryID

Applicant Information

Name*

First Last

Phone*

Email*

Enter Email Confirm Email

Marital Status*

Age*

References

Please provide two references

Name*

First Last

Phone*

Relationship

Name*

First Last

Phone*

Relationship

Address

Current Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Have you been at this address for more than two years?

Previous Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Employment

Occupation*

Employer*

Have you been with this employer for more than one year?*

Previous Occupation*

Previous Employer*

Are you a US Citizen?*

Co-Applicant Information

Is there a co-applicant for this adoption?*

Name*

First Last

Age*

Marital Status*

Phone*

Email*

Enter Email Confirm Email

Co-Applicant Employment

Occupation*

Employer*

Have you been with this employer for more than one year?*

Previous Occupation*

Previous Employer*

Have you or any member of your household have a history of allergies to animals or asthma?*

Please Note: We do not have pure-bred kitties that are hypoallergenic.

Are there other people living in the house with you?*

Please indicate each member of your household in the appropriate tables below.

Adult Members of Your Household (Age 18 and Over)

Adults

Name

Age

Relationship

Minor Members of Your Household (Under Age of 18)

Minors

Name

Age

Relationship

Related to Family Members

Is everyone in the household in agreement about this potential adoption?*

What will you do if you have a roommate / family member who may be allergic?*

Have you or any member of your family been accused of and/or found guilty for animal neglect, cruelty or similar offense?*

Household Information

Home Type*

If Other, please explain*

Home Status*

Pet Deposit*

Additional Pet Rent*

Rental Restrictions for Pets (i.e. max 2 pets)

Landlord*

Landlord Phone*

If Other, please explain*

Please select all that apply to your current home

Doggie Door

Pool

Fenced Yard

Acreage

Livestock / Farm Animals

Do You Plan to Move in the Future?*

What Will You Do if Your Future Residence Does Not Permit Pets?*

Under what conditions would this animal be outside?*

Do you have animals visit your home regularly?*

If Yes, what type and how often?*

Do you have children visit your home regularly?*

If Yes, what age and how often?*

What will you do with the animal if you have to move?*

List All Past and Present Pets for at least the past 10 years.

Current Pets

Do you currently have any pets?*

Current Pets*

Name

Species / Breed

Spayed / Neutered

Age / Years Owned

Year Last Vaccinated

Previous Pets

Have you previously had any pets?*

Previous Pets*

Name

Species / Breed

Status

Age

Years Owned

Additional Explanation for Previous Pet(s)

General Pet History Information

Have you ever had a cat declawed?*

If Yes, please explain*

Have you ever had a cat with Feline Leukemia or AIDS?*

Have you ever rehomed an animal or surrendered an animal to a shelter or rescue group?*

If Yes, please explain*

Veterinarian

Current Veterinarian*

Emergency Veterinarian*

Animal of Interest

Name of animal you are interested in*

Have you met this animal in person?*

What is the reason for adopting this animal?*

If Other, please explain*

What do you like about this animal?*

Do you have experience with the breed?*

What personality traits do you like in a animal?*

What personality traits do you dislike in a animal?*

Describe any personal situations that might cause you to have to return this animal?*

How many hours per day will this animal be alone?*

Under what circumstances would you consider declawing (Cat) or tail docking / ear cropping (Dog)?*

Behavior Challenges

In each of the fields below, please explain how you would handle each of the behaviors listed.

Scratching*

House Soiling*

Fearful / Shy*

Clashes with Current Pets*

Financial Concerns

Properly cared for animals can cost between $500-$1,000 per year. This includes yearly vaccinations, vet checkups, supplies, food, water and litter.

Are you financially able and willing to spend at least this amount each year?*

Are you aware that adopting an animal is a lifetime commitment that may span 20 years or more?*

In an emergency, what amount are you willing to pay for veterinary costs?*

What would you do with a bill greater than that amount?*

If for any reason you are unable to care for this animal (e.g. injury, illness, finances, death, etc), what would happen to him/her?*

Discovery

How did you hear about us?*

In Store

Pet Search Site

Friend / Family

Social Media

If In Store, please specify store Location*

If Other Store Location, please specify store*

If Pet Search site, please specify which site*

If Social Media site, please specify which site*

Disclaimer

By submitting this application, I/We attest that the information provided herein is accurate to the best of my/our knowledge. I/We understand that the following information is requested so that Saving One Life can assist me / us in the selection of a lifetime companion. The animal's welfare is Saving One Life's foremost concern. Saving One Life reserves the right to deny adoption to anyone.

I have read, reviewed and agree to all stipulations described above*