Phone (include home, work and cell)
Employer or School Name
List the animal(s) name that you are interested in from our web site:
Type of residence?
If renting, can you provide proof that you are allowed to have a dog or cat?
Landlord's name
Please list any other family or friends that are living with you and their relationship to you.
Please describe your weekday schedule. Include how many hours a day your dog or cat would be alone.
What age animal are you seeking?
Do have a breed or breed mix preference? If so, describe.
Do you prefer a male or female animal? Or no preference?
Please describe any traits you would find desirable in your next pet.
Please describe any traits you would find undesirable in your next pet.
Please list the children's ages that live in your home. Or say 'no children.'
Please list your current animals. Be sure to include the breed, weight, and sex of your dog(s).
Please tell us about any previous pets and, if your pet is deceased, please the circumstances of his/her death.
Please provide the name of name of your vet (current or future). NOTE: If you do not provide this information, we cannot proceed with your application.)
Please provide any other information to help us match you with the right pet.
Cat Only: Do you prefer indoor or outdoor?
Cat Only: Do you plan to declaw your cat? Why or why not?
Cat Only: Are you seeking a declawed cat?
Email Address
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