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Animal Adoption Application
This application must be complete to be accepted. Incomplete applications will not be reviewed or approved. Make sure to be as detailed as possible on all answers.
* Indicates required question
Full Name (First and Last)
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Your answer
Date of Application
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MM
/
DD
/
YYYY
Address
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Your answer
Phone Number
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Your answer
Email Address
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Your answer
Age
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Under 21
21-29
30-39
40-49
50-59
60-69
70-79
80+
Employer
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Your answer
What animal are you interested in?
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Your answer
Why are you interested in this animal?
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Your answer
What energy level are you looking for?
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lowest energy level
1
2
3
4
5
highest energy level
Do you currently have animals?
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Yes
No
If yes, please list : name, age, gender, weight below.
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Your answer
Are your current animals sterilized? (Spayed/neutered)
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Yes
No
If no above please explain. If Yes above write N/A.
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Your answer
Are your current animals completely vaccinated?
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Yes
No
If no above please explain. If yes above write N/A.
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Your answer
Are your animals on heart worm preventative and flea/tick medicine?
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Yes
No
List all people in your home. Names, ages, genders.
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Your answer
Have you ever given an animal away?
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Yes
No
If yes above, please explain. If no write N/A.
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Your answer
Please list any and all animals from your past and what happened to them.
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Your answer
Under what circumstances would you give an animal away?
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Your answer
Current veterinarian. Must list : name, address, phone number, name the account is under.
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Your answer
When was your last trip to your vet and what was it for?
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Your answer
Do you live in a:
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House
Condo
Apartment
Mobile Home
Duplex
Social environment:
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City
Suburbs
Country
Do you:
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Own
Rent
If you rent : you must provide landlord information : name, address, phone number.
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Your answer
Do you have a fenced yard?
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Yes
No
If no yard, how do you plan to take the dog to the bathroom?
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Your answer
How will you exercise the animal?
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Your answer
Do you have children that visit your home on a regular basis?
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Your answer
Is everyone in your home agreeable to getting a rescue animal?
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Your answer
Where will the animal spend it's time?
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Your answer
How many hours will the animal be alone during the day?
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0-1
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
9-10
10+
Where will the animal be when you are not home?
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Your answer
Do you understand that even though a dog may be housebroken in their foster home, when they move to a new environment there is an adjustment period where they may have accidents in the new home? Housebreaking techniques will need to be utilized.
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Yes
No
What type of training methods will you use? Please give details and examples of what you have used in the past.
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Your answer
Are you physically able to care for this pet? If limitations, please explain.
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Your answer
I understand that proper food, grooming, and veterinarian care may be costly, and I am able and willing to meet the needs of my adoptive animal.
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Yes
No
I grant Willow Haven Animal Sanctuary permission to conduct a home check.
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Yes
No
Are you planning on enrolling the dog in obedience class? If applying for cat click N/A.
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Yes
No
If needed
N/A
Do you have any other additional information you would like to provide?
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Your answer
I understand by submitting this application, I am declaring that the information I have provided in this application is complete and correct.
*
Yes
No
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