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Dog/Cat Adoption Form
Personal Information
E-Mail:*Valid e-mail is required
First Name:*
Last Name:*
Spouse/Partner/Housemate Name:
Address Line 1:*
Address Line 2:
Zip Code:*
How long have you lived at your current address?*
If less than three years, please list previous address?
Marital Status:
Date of Birth:
How many children live in the home:*
How many adults live in the home :*
Do all adults work outside the home:*
Yes No 
Do you:*
Own your property
Rent your property
Live with your parents
If renting, does lease allow for pets?
Yes No 
If renting, please provide landlord`s name and telephone number:
Adoption Related Information
Which pet are you interested in?*
Reason for adopting a cat or dog:*you may choose more than one
Do you have a fenced in yard?*
Yes No 
Do you currently own a pet?*
Yes No 
Please list all companion animals you currently have:include type of pet & age
Where will this pet spend most of it`s time?*
How many hours a day will your new pet be without human companionship?*
Pets usually require minimum cost of $500 per year for veterinary care, food, and other related expenses.
Are you willing and able to afford these costs?*
Yes No 
Have you ever had to give up or find another home for a pet in the past?*
Yes No 
If yes, please explain?
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