Adoption Form – Annie's Orphans

Name *

First

Last

Date

Breed/Age

Or enter name of or description of the animal you are interested in adopting,

Home Phone *

Work Phone

Age of applicant *

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Do you live in. *

Do you

Rent
Own
Other

How long at this address? *

Do you live with your parents ?

** YOU MUST PROVIDE THE NAME AND PHONE NUMBER OF YOUR LANDLORD OR CONDO ASSOC. WITHIN 24 HOURS OR WE WILL MOVE ON TO THE NEXT APPLICANT.

Landlord's name

Landlord's Phone

Applicant's Employer *

How Long Employed? *

Does anyone in your home have allergies to animals?

Does anyone have asthma?

Do you have a TOTALLY fenced in yard?

Size of your yard:

Type of Fence:

Height of Fence:

Where will the pet be kept during the DAY?

Where will pet be kept during the NIGHT?

If the Answer above is "INDOORS" where during the day and night?

INSIDE - DAY

(ie: Garage, Bedroom, Run of the House, Finished basement, Unfinished Basement, etc.)

INSIDE - NIGHT

(ie: Garage, Bedroom, Run of the House, Fnished basement, Unfinished Basement, etc.)

During Routine Absences

(ie: errands, work)

Do you have a

How many ADULTS live in your home?

How many CHILDREN live in your home?

Ages of children living in your home

Do children frequently visit & if so , what are their ages

Is anyone home during the day? how long?, Who?

Can they handle the animal you want to adopt?

ALL MEMBERS OF THE HOUSEHOLD, INCLUDING PETS, MUST VISIT WITH THE ANIMAL BEFORE THE ADOPTION IS APPROVED.

How many hours will the pet be without humans each day?

Who will be the primary care giver?

Who will care for your animal while you are on vacation?

What will you do with animal if you move?

Are you willing and able to provide pet care for the next 10 or more years, including vet checks, vaccinations, boarding, medical care, indoor housing etc.?

What do you think pet care costs per year, including annual vaccinations, food, toys, minimal ordering, grooming, etc.?

Are you willing and able to support a pet?

We require all animals adopted fromus to be spayed or neutered. Do you have any questions or reservations about this policy?

Please list all pets you have owned in the past 10 years. If none, then include pets owned in your childhood (clearly indicate between childhood pet & pet as an adult). Include any pets residing in your home but which you do not own.

Owned Pet 1