Adoption Form

Name of Pet

Please Fill out the following questionaire in as much detail as much as possible. Our goal is to match the right pet with the right owner. The information requested helps us to find a permanent home for each animal.                   ALL QUESTIONS MUST BE ANSWERED FULLY IN ORDER FOR US TO PROCESS YOUR APPLICATION.       THANK YOU!

Name  

Address   
City,
State,
Zip




1.  How long have you lived at the above address? 

2.  Do you live in a

3. Do you rent? 

4. If yes, please provide your landlord's name & phone number 








5. What type of pet do you want to adopt?



6. Are you interested in adopting this pet for your self or someone else?



7. Are you or your spouse currently employed? 

8. Are you at least 21 years of age? 

9. How many people currently live in your household? 

10. What are their ages? 







11. Will anyone be home/available during the day? 

12. If adopting a dog or puppy, what type of training will you use to break undesireable behavior, such as                      housebreaking, digging, chewing, etc... 









13. If adopting a cat or kitten, how will you handle undesireable behavior such as scratching furniture, scratching          people, biting, not using the litter box, etc...










14. Have you ever owned a declawed cat? 


15. Is Declawing an option for you? 

16. Have you ever adopted a pet from START before? 

17. If yes, When & Where is the pet now? 







18.Will your new pet live 

19. Where will he or she sleep? 


20. Is there a yard available for the pet? 

21. Is the yard completely fenced? 


22. What type of fence do you have? 

23. Do you presently or in the past 5 years own any pets? 

24. If yes, please describe






25. Are your current pets up to date on shots?

26. Are your current pets spayed or neutered? 

27. Are your current pets on heartworm preventative? 

28. Have you in the past 5 years used a veternarian? 

29. If yes, which ones? Name & Phone Please








30.Do you agree to return the pet to be spayed or neutered if it has not already been?

31. Are you aware of the costs of preventative & other medical care for your new pet?

32. If yes, are you willing to spend the money to keep him/her healthy?

33. Are you willing to have your pet checked yearly by a veterinarian?

34.Have you ever had a pet with Parvo, Feline Leukemia or Aids? 

35. Have you had a pet die in the last 5 years?

36. If you answered yes to #34 or #35 Please Explain:







37. Would you authorize a member of S.T.A.R.T. to do a home visit?


38. Would you authorize a member of S.T.A.R.T. to do a Vet Check ?



Thank you for your time, we will contact you within a few days

Please give us time to process your application as we are all volunteers & all work!

Thanks Again .... We look forward to speaking with you !!!



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Your email address
Phone number
HouseApartmentCondoMobile HomeOther
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DogCat PuppyKitten
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InsideOutsideBoth
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PrivacyPicketBrickCattleOther
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