About You and Your Household

Some basic information and how we can get in touch with you.

Applicant Name: _(Required)

Street Address:

Street Address:

City:

State:

Zip:

Phone# _{555-555-1234 (Required)}

Secondary Phone# _555-555-1234

Email Address: _(Required)

Age:

If you are interested in one or more specific animals you have either seen on our online listings or met at an adoption fair, please list their name(s) here:

Employment Info

Occupation/Employer Name:

Home Environment

We want to make sure that the animal you're interested in is a good fit for your home environment.

Have you applied to any other rescue group? If so, please list the group name and date of application (this will enable us to coordinate placement efforts): YesNo

Is there a pet limit in your city or county? If so, what is the limit? YesNoUnknown
May we visit your home? YesNo

Please list the names and ages of all persons who live in your household (or who visit regularly):

Name:
Age:   
Pet Allergies? YesNo

Name:
Age:   
Pet Allergies? YesNo

Name:
Age:   
Pet Allergies? YesNo

Name:
Age:   
Pet Allergies? YesNo

What pets do your currently have in your household?

Type: ---SpayedNeutered
Age:   ---IndoorOutdoorBoth

Type: ---SpayedNeutered
Age:   ---IndoorOutdoorBoth

Type: ---SpayedNeutered
Age:   ---IndoorOutdoorBoth

Type: ---SpayedNeutered
Age:   ---IndoorOutdoorBoth

If you Rent, complete the following:

Landlord’s Name:
Landlord's Telephone Number: _555-555-1234
Does your Landlord allow pets? YesNoUnknown

A Few Additional Details

About The Adoptive Animal.

Reason for adopting the animal: Myself, As an IndividualMy Household/FamilyA Friend or Relative, as a GiftA Classroom, at a school where I am a staff memberAnother situation not described here

Are you planning to bond this animal with another pet you already own? YesNo
Would you consider a Special Needs Animal, such as one who requires medication for a permanent but controlled condition? YesNo
Where will your pet be kept during the day?
And at night?
How many hours will the animal spend alone each day?
Rescued Animals have sometimes been in neglectful and/or abusive situations and therefore, may experience difficulty making the transition to a new home. Are you willing to be patient while your animal adjusts to its new home? YesNo
How long do you feel an animal should be given for an adjustment period?
What type of bedding/substrate/litter do you plan to use for your pet(s)? ---Wood ShavingNewspaperOther Paper Based BeddingFleece BeddingOther Fabric BeddingOther Bedding TypeUnknown/I need a recommendation
Do you have experience caring for the species of pet you are interested in adopting? YesNo
Do you have an exotics vet you would contact if a medical need arose? ---No, I need a recommendation for a vet to contactYes, I have a vet I would plan to contactYes, I have a vet who has treated my pets beforeYes, I am a Veterinarian or work closely with one
Please describe the type of habitat your adopted pet(s) will be living in;
If you know what type of habitat you will be using, provide either the make and model of the cage, or overall dimensions and a description. If you do not know what habitat you will be using, please indicate you need a recommendation.

Please describe where in your home your adopted pet(s) habitat would be located.

Any additional notes, questions or comments you would like to submit with your application

Your Experience with Animals

Please list all pets you have owned in the past three years:

Pets Name: ---MaleFemale
  Species: ---SpayedNeutered
  What happened to the pet?

Pets Name: ---MaleFemale
  Species: ---SpayedNeutered
  What happened to the pet?

Pets Name: ---MaleFemale
  Species: ---SpayedNeutered
  What happened to the pet?

Pets Name: ---MaleFemale
  Species: ---SpayedNeutered
  What happened to the pet?

Vet Reference

Please identify all veterinarians used for the past three years where the vaccines and other vet records are kept.
Please include Name, Address & Phone #

Personal References

If no vet reference is available, please include at least two personal references. Family members cannot be personal references.
Name, Phone #

Have you sold, given away or surrendered a pet to a shelter?

Have you or any member of your family/household been cited for animal neglect/cruelty in the past?

(Required)
In submitting this application, I/we hereby certify that all the information provided on this application is true, complete and accurate to the best of my/our knowledge. I/we attest that I/we have read the Terms and Conditions of Adoption and also understand that completion and submission of this application does not guarantee adoption of an animal and Snooty Giggles Dog Rescue reserves the right to refuse any adoption.