SMALL & FURRY CRITTER ADOPTION APPLICATION

YOU MUST FILL OUT EVERY BLANK IN ORDER FOR YOUR APPLICATION TO BE CONSIDERED. IF YOU LEAVE A BLANK EMPTY YOU WILL NOT BE CONSIDERED TO ADOPT AN ANIMAL. IF THE BLANK DOES NOT APPLY TO YOU THEN PLEASE PLACE "N/A" IN THE BOX TO REPRESENT THE PHRASE "NOT APPLICABLE". THANK YOU.

I want to adopt a:



I am interested in a:
Male
Female
1 of each
Sex doesn't matter

Date:

Full Name:

Home Phone Number:

Cell Phone Number:

Additional Phone Number:

Address:

City:

State:

Zip Code:

E-mail Address:

Place of Employment:

Work Phone Number:

Date of Birth (mm/dd/yyyy):

Driver's License Number:

State of Drivers License:



Is this animal a gift?:
Yes
No



If this animal is a gift, does the recipient know?:
Yes
No - It's a suprise
N/A

Brag about your CURRENT Fur Babies. Tell us about their personalities:


Why are you adoptiong this animal?:


For whom are you adopting this animal for?:

What are those persons ages?:

Who will be the primary caretaker of this animal?:

What experience do you and the potential primary caretaker have with this species of animal?:


Please describe the habitat in which the animal will be living:


What type of bedding will be used in the animals habitat?:



This animal will live:
Indoor Only
Outdoor Only
Mostly indoor but outdoor when its nice
Indoor unless it stinks then it will go outside



Do you have cats and/or dogs?:
Yes
No

If Yes, How will you keep the cats/dogs from harming the new addition?:

Please list those persons that live or frequent the home of the potential owner:
Name:
 Age:
 Relationship:
Name:
 Age:
 Relationship:
Name:
 Age:
 Relationship:
Name:
 Age:
 Relationship:
Name:
 Age:
 Relationship:
Name:
 Age:
 Relationship:
Name:
 Age:
 Relationship:
Name:
 Age:
 Relationship:



Have you ever adopted from RePets or the BGWC Humane Society before?:
Yes
No

If Yes, when and what?:

Please list those pets that you currently own:
Name:
 Age:
 Type:
Name:
 Age:
 Type:
Name:
 Age:
 Type:
Name:
 Age:
 Type:
Name:
 Age:
 Type:
Name:
 Age:
 Type:
Name:
 Age:
 Type:
Name:
 Age:
 Type:

Please list those pets that you no longer have:
Name:
 Type:
 Why no longer have:
Name:
 Type:
 Why no longer have:
Name:
 Type:
 Why no longer have:
Name:
 Type:
 Why no longer have:
Name:
 Type:
 Why no longer have:
Name:
 Type:
 Why no longer have:
Name:
 Type:
 Why no longer have:
Name:
 Type:
 Why no longer have:

What Vet Name/Vet Office do you use?:

What is this vet's full address?:

What is this vet's phone number (with area code)?:

If adopting for a child, what will happen to this animal(s) if the child no longer wants it or wants to care for its cage?

If you wont be home for a few days, Who will care for your animals?:



If this animal becomes ill are you financially able to take him/her to the veterinarian?:
Yes
No

If No, how will this animal be cared for?:

***If Yes we recommend All Creatures Animal Hospital on Lovers Lane, because they not only support the Humane Society and RePets, but because they are able to treat small critters.***



Do you have expirence with this type animal?:
Yes
No

If yes, please explain:



Do you plan to breed this animal?:
Yes
No
Maybe later, but not right now.



Are you buying this animal for snake food?:
Yes
No
If it bites me or I'm tired of it I will feed it to my snake.



Do you plan to eat this animal?:
Yes
No
No, I only eat the ones I trap/shoot.



Are you alright with a home visit, so that we can make sure the animal is going to be living in the best environment?:
Yes
No

If no, please explain why?:



Please describe your living situation. Do you?:
Own
Rent
Rent to Own
Live with parents
Live with friends/relatives

If you live with either your parents, friends, or relatives please give us their full name and phone number (with area code):

If you live with either your parents, friends, or relatives and/or have a landlord, how do they feel about you bringing a new animal into the home?:

What is your landlord's FULL NAME?:

What is your landlord's phone number (with area code)?:

When is the best time to reach your landlord?:



Do you understand that if we feel the animal(s) you have chosen is not likley to work out in your situation, we may decline the application, FOR ANY REASON?:
Yes
No



Do you understand that RePets is not responsible for any medical care once the animal(s) in adopted?:
Yes
No



Do you understand that sometimes rescued animals have come from traumatic situations, and are not always at their best behavior?:
Yes
No



If the animal(s) you adopt is taken home and develops bad behavior are you able to help the animal(s) work thru its issues?:
Yes
No

If no, what will you do with the animal?:

***RePets will disclose any good or bad behavior to the best of our knowledge.***



Do you understand there is NO REFUND of any adoption fees if the animal does not work out?:
Yes
No

Part of the adoption process is that you the adopter will sign a contract promising that you will care for the animal(s) in a responsible and humane way, and if you are ever unable to care for this animal(s) you agree to bring them back to RePets or take the animal(s) to the Humane Society.

By initialing I understand that if granted permission to adopt this animal (s) that I am under contract to bring the animal(s) back to RePets or take the animal(s) to the Humane Society if I am not able to properly care for this animal(s)in a responsible and humane way:



Do you understand that if ANY information given on this application is found to be false, or if we find the animal you are adopting from RePets is not being given proper care (personal or veterinarian) we WILL reclaim the animal(s)?:
Yes
No

***If this application is not completely filled out it will not be considered for the animal you have requested, we recommend that you look to see if you missed any questions.***

Your application WILL NOT be considered if you skipped any question. If the question didn't apply to you, mark it N/A.