Pet Center — Adoption Application

APPLICANT INFORMATION

Name

(optional) Reference Date

Address

Apt / Unit #

City

State

Zip

Phone number

Email

Additional information (anything we should know)

ID / Driver's license #

Spouse / Partner name

Employment status

Employed full-time Employed part-time Unemployed Student Retired

LIVING ARRANGEMENT

Do you: Rent / Own / Live at parents

If renting - landlord allows pets?

Yes No

Landlord name & phone

Type of home

Length of time at current address

Who lives with you? (list Name — Age)

If you owned animals in the past 10 years and no longer have them, what happened?

CURRENT PETS, PET OWNERSHIP, AND VET CARE

Can you afford to care for a pet?

Yes No

Do you have a veterinarian?

Yes No

Veterinarian's name

Veterinarian Address

Veterinarian Phone

Would you allow us to speak with your vet for health info?

Yes No

Current pets (Name / Breed / Age / Spayed?)

Pet Name	Breed/Species	Age	Spayed/Neutered

PET CARE

Where do you keep your pet when not at home?

When inside, how will you keep your pet?

Free inside the house Confined to crate Other

When outside, how will you keep your pet?

Fenced yard On a leash Garage Other

How will you introduce your new pet to existing pets?

How will you handle undesirable behaviour?

ADOPTION INFORMATION

I want to adopt a (Cat/Dog/Other)

Sex preference

Why adopt? (check all that apply)

Companionship Children responsibility Love animals / help a pet Want to breed Mouse control Gift for someone Companion for another pet Other

Primary caregiver

I UNDERSTAND & AGREE

The above statements are true to the best of my knowledge.
I will provide food, water, and shelter at all times.
Pet Center cannot guarantee temperament/behavior.
Leash/containment rules may apply by local law.
I will follow up with my vet within 10 days.

Applicant signature (draw below)

Signature preview

HOW DID YOU HEAR ABOUT US?

UPLOADS (required)

Government ID (front & back) — required

Click or drag files here (max 5)

Proof of Address — required

Click or drag files here (max 5)

Proof of Funding (if required)

Click or drag files here (max 5)

DATE SUBMITTING

Submission date *

I confirm the information above is true and I agree to Pet Center's terms.

Please confirm your information carefully — you can only submit this application once.

APPLICANT INFORMATION

LIVING ARRANGEMENT

CURRENT PETS, PET OWNERSHIP, AND VET CARE

PET CARE

ADOPTION INFORMATION

I UNDERSTAND & AGREE

HOW DID YOU HEAR ABOUT US?

UPLOADS (required)

DATE SUBMITTING

MANAGEMENT APPROVAL

Quick Notes