Name:
Address:
Home number:
Cell:
Email address:
What time is best to call?
Name of clinic/hospital:
Vet’s Name:
Phone number:
Do you have a fenced in yard? Yes No
If yes, how tall, if no, how will you keep the animal safe?
Are you willing to go through basic obedience classes? Yes No
If no, why not?
Will this dog be: indoors outdoors both
If the dog will be primarily outside, do you have adequate shelter for it?
Will this cat be an indoor cat? Yes No
If no, how will you keep it safe?
Do you: Own a home Rent a home Live in an apartment Live in a Dorm
If you don’t own your home, will your landlord allow you to keep this pet?
How long have you lived here?
What small children live in the home (list names and ages):
List all four legged pets you own and how long owned:
Why do you want a pet?
How often will you exercise your pet and how?
Are you willing and able to deal with all the issues that may come with owing a pet? (chewing, digging, barking etc) Yes No
If yes, how, if no, why not?
If you go out of town, what will you do with your pet?
If you move, what will you do with your pet?
If you have children, please think carefully before applying to adopt an animal. Kids and animals are very unpredictable together. Proper supervision is very important when the animal and your kids are playing. We reserve the right not to place an animal in a home if we feel it would be a risk to the children in the home or the animal.
If once you get the animal in your home you see that there are problems between your children and the pet please call us. We will come get the animal. Our primary concern is safety for all involved in an adoption.
TLC Animal Organization (TLC) does our best to make sure the animals we adopt out have good temperaments, are healthy and go to the home best suited to them. However, we are not liable for any health or behavioral issues the animal may have after adoption. We are also not responsible for any property damage they may cause. Should you become unable to properly care any animal adopted from TLC, the pet must be returned to us.
I acknowledge that all the information on this form is true and correct. I understand that any misrepresentation of fact may result in the removal of the adopted animal from my home.
Signature (Applicant)_______________________________________Date________________
Signature (TLC representative)______________________________Date________________