Your Goodest Boy Or Girl Awaits. Adoption Form. Name * First Name Last Name Name of animal you are interested in adopting. * Email * Date * MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Are at least 18 years of age? * Yes No Occupation? Spouse or Partner's Occupation? * List all members of your household and their ages: * Do you own or rent? * Own Rent How long have you lived at this address? * If you rent, please provide landlord's name and phone number. * Is there a limit as to how many pets you can have where you live? If so, what is it? * Are there any breed restrictions where you live? If so, what are they? * Do you currently own any pets? * Yes No If yes, what kind, sex, are they spayed/neutered and how long have you had them? If you currently own pets, are they all up to date on their vaccinations, heartworm prevention, and flea prevention? Leave blank if you currently have no pets. Yes No Name and phone of current vet, if you have one. When was your last vet visit and for what reason? Leave blank if you've never had a pet. Are you willing to take responsibility for this pet for the rest of its life? * Yes No Are you aware there is a period of adjustment for each rescue to it's new surroundings which may include potty accidents, chewing and digging, or other 'undesirable' behaviors? * Yes No Are you willing to spend the necessary money for vet bills that may be incurred to keep your pet healthy, knowing in advance that the average yearly cost of having a pet is approximately $700 - $1,000? * Yes No Who will be the primary caretaker for the pet (feeding, attention, training, exercise)? * Where will the pet sleep? * Where will the pet stay while you are away? * Have you ever sold, given away or surrendered a pet to a shelter or another individual? * Yes No If yes, please explain: If the adopted animal makes a mistake, please describe what sort of correction you will make. * Is your yard fenced or open? * Fenced Open If fenced, please provide the approx. height: Dogs need daily exercise! Please explain what kind of exercise you plan to provide: Reference 1 * Name * Phone Number * Relationship to applicant, and how long have you known them. (no family) Reference 2 * Name * Phone Number * Relationship to applicant, and how long have you known them. (no family) Reference 3 * Name * Phone Number * Relationship to applicant, and how long have you known them. (no family) I agree as an adopter, I will not be reimbursed for vet care or other extraneous costs not specifically approved, in writing, by an approved LnD Animal Rescue, partner. * Agree Disagree I attest the information provided on this application is true and accurate to the best of my knowledge. I hereby permit LnD Animal Rescue (LnD) to contact my Veterinarian. I permit that if my adopted pet is not already altered I agree to take the animal to be altered and provide proof of alteration. If I miss the appointment set by LnD, LnD can take the adopted pet back into LnD’s possession, with no refund given. If for any reason I am unable to keep an adopted pet from LnD for its entire life, I will contact LnD and make arrangements to return the pet and no refund will be given. Further, I agree to not sell, give away or dispose of the pet in any other manner (except euthanasia for medical reasons at the advice of a licensed vet) without prior consent of LnD. * Agree Disagree We will review your application and be in touch soon. Thank you! View fullsize View fullsize View fullsize View fullsize View fullsize View fullsize View fullsize
