Adoption Form
We appreciate your interest in adoption! Kindly remember that completing the adoption application does not assure adoption. Adoption applicants must be at least 18 years old.
Personal Commitment
Are you both capable and willing to make a lifelong commitment to the care of this pet?
Name of the pet you are interested in adopting:
Personal Information
Your Name:
Phone Number
May We Text You?
Your Date of Birth
Address
Your Address
Household
Do you rent or own your home?
If you rent does your lease allow pets?
What type of residence?
Adults in Your Household (Other than Yourself)
Please give a name and age of each adult living in your household (Enter 'none' if applicable)
Children in Your Household
Please give a name and age of each child living in your household (Enter 'none' if applicable)
Has anyone in your household been convicted of a child or animal welfare law violation, including but not limited to neglect, cruelty, or abandonment?
References Outside of Household
Reference #1
Name
Your Relationship to Reference
Phone Number
Current Veterinarian (If Applicable)
Veterinarian's Name
Veterinarian's Phone Number
Hospital Name
Past and Present Pets
List out your past and current pets! What type of pets are they? How old are they? And where are they now?
Life with your Pet!
Please provide a brief description of your experience with this particular type of furry friend. If you haven't had any experience, please share the research you've done
What would you do if the pet is destructive? (noisy, scratching, chewing, house soiling)
Have you ever surrendered a pet? If so what was the reason?
Have you ever had to put a pet to sleep for any reason other than incurable illness? If so what were the circumstances
Why are you interested in adopting this animal?
Where will this pet primarily reside?
Please describe what cage or living circumstances this pet will be living in
Who would assume responsibility of this pet if you were no longer able to take care of them?
Certify and Complete Information
I certify that the information given on this application is true and complete. I also understand that falsified information or significant omissions may result in my disqualification from this and future adoptions from the Yeager Co. Animal Liberation Rescue. I hereby agree to hold the Yeager Co. Animal Liberation Rescue, their trustees, executive director, board of directors, employees, agents, volunteers, and assigns harmless from any and all liability on account of any personal injury or illness that I, my family members, or my pets may sustain, or damage to my property while interacting with an animal or animals. I agree to abide by all rules and regulations set forth by Yeager Co. Animal Liberation Rescue, written, spoken, and implied. I understand that this adoption may be denied for any reason deemed fit byYeager Co. Animal Liberation Rescue. I understand that there are no refunds on adoption fees. I understand that there may be a home check prior to adoption, and welfare check(s) after adoption.
Date
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