Adoption Application

Random visit?

Yes

What are the height and dimensions of fenced in area?

Out of state?

Spouse's Occupation *

Mouser

Employer: *

How many hours a day will your pet be left alone?

Please Explain: *

Cell Phone: *

Email *

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Would you object to a home visit?

Yes

Address *

List names, telephone and e-mail addresses of three personal, unrelated references who you have known for at least three years.

Home Phone: *

Name: *

Other (please explain):

Size

Small

Medium

Large

Extra Large

If no fenced in backyard, how will the pet be exercised and allowed to eliminate?

Age or Birthdate: *

Sex

Male

Female

Are there any specific habits or problems that you are not willing to work with? If so, please specify:

Other (please explain):

How will your animal travel to the vet and other places (car, crate, van, back of truck, etc.)?

What other animals do you currently own? Number of dogs; number of cats; other? Please list breed, sex and ages of all pets: *

Companion for self

Do you know that the life expectancy of a pet may be 10 – 15 years? Are you willing to take responsibility for your pet’s entire life?

Yes

Work Phone:

Is this likely to change in the future?

Yes

City/State *

Name, address, and phone number of veterinarian:.

PET ADOPTION QUESTIONNAIRE

After receiving your completed application, we will review it, contact you and schedule a home visit. Vet and
personal references will be checked. Much consideration will be given to helping you meet a perfect match! Often,
we receive many applications on one particular animal. Our goal is to place the animal in the best home possible
based on its needs, personality and past history. Please note that adoptions are NOT done on a first come, first
serve basis, and filling out an application does not guarantee the adoption of any animal. We reserve the
right to refuse any applicant for inaccurate or false information. At all times, we look to place the animal in
the best possible home. All pets are spayed or neutered prior to adoption with the exception of puppies under the
age of six months. A separate spay/neuter contract will need to be signed during the adoption process. Thank you
for your cooperation.

By signing this application, I attest to the fact I am 21 years of age or older and the above information is correct. I, ________________________________________, hereafter referred to as the adopter, hereby agree that the above described animal is being adopted by me solely as a pet for myself and/or my immediate family. I agree that I will not sell, give away or otherwise dispose of said animal to any person(s), dealer, retailer, auction, institute or any other entity for any reason. If at a later date I am unable or unwilling to keep this pet, I agree to contact A Better Life Animal Rescue and return the pet to them. I hereby agree to care for the above-described pet in a humane and responsible manner and to provide it with clean and adequate shelter, food, water and veterinary care. I further agree that said pet shall reside inside my home. NO CHAINS, NOT TIED UP OUTSIDE, NO WIRELESS FENCES ARE ALLOWED AND PET SHALL NOT BE ALLOWED TO ROAM FREELY. Adequate shelter must be provided against weather and sun if a dog is outside for any period of time. I hereby agree that this pet shall wear a collar or harness with identification tags at all times with the exception of being crated in the home. The pet WILL NOT WEAR SHOCK OR ANTI-BARK COLLARS. I hereby agree that the adoption fee helps to cover the current owner’s expense of raising and caring for the animal. I hereby understand and agree that the current owner makes no representations or warranties, expressed or implied, regarding the above-mentioned animal's temperament and is hereby absolved from any liability for future damages or injuries caused by said animal. I also understand and agree that the current owner further makes no guarantees, expressed or implied, of the suitability of the animal to the adopter and/or his/her family. 1 Current owner is defined as the person who originally held the above described animal in possession. 2 Adopter is defined as the person who accepts for adoption the above described animal. We reserve the right to refuse any applicant. *

Click here to agree. This checkbox constitutes an electronic signature.

May we contact your landlord?

Yes

All pets have been known to have behavioral challenges whether barking, mouthing, pulling on leash, digging, etc. How do you intend to handle these potential problems?

If you answered yes, please explain:

Personality:

Animal Rescue, Inc.

P.O. Box 8311, Morganton, NC 28680

(828) 584-6767

For spouse

Spouse's Employer: *

Healthy animals need routine veterinary care and regular vaccinations. What is your estimate of these costs?

What made you choose this particular pet?

Why do you want a pet? Number those that apply in order of importance, 1=most important.

Are pets spayed/neutered? *

Yes

How long have you been at this address? *

Please explain:

Do you rent?

Yes

Overseas?

What member of the family will take MAJOR responsibility for this animal?

Name of condo or apt complex, if applicable:

What is the activity level of your household?

Busy-visits by friends, meetings, children, and parties at home

Noisy-television, stereo, machinery, tools, kids playing

Moderate- normal comings and goings

Quiet homebodies, few guests

A Better Life

Will you keep an I.D. tag on your pet?

Yes

If no, please explain:

Please tell us a little about yourself and why you feel you could provide a good home for a rescued companion animal:

Driver's License #: *

How often do you leave town?

Give us a little information on what you are looking for in a pet: *

How did you hear about our rescue and/or who referred you to us?

Is anyone in the home a smoker?

Yes

For other pet

Occupation *

What will happen to the pet if you move locally?

DO YOU HAVE A FENCED IN YARD?

Yes

For Children

How soon after the pet arrives home will it be left alone?

Where will the pet sleep at night?

If there is a particular pet you are interested in please list name:

How will you plan to care for your pet while you are away?

How many adults are living in your home? Please list their ages:

Where will your pet be kept when left alone?

Spouse or Roomate *

All pets take time to settle into their new home. How much time are you willing to give your pet to settle in and become comfortable?

If so, is it connected to the house (backyard attached to backdoor, etc.)?

Yes

If you rent, do you have the landlord's permission to have a pet there?

Yes

What actions will you take or not take to help them adjust?

Type of environment:

Rural

Suburban

City

How will you protect them during the adjustment period?

What pets have you owned before? Please indicate whether you still have these pets, and if not, what happened to them:

Landlord's name & phone #:

If yes, please explain:

How many children are living in your home? Please list their ages:

Do you believe in crates? If so, for what purpose?

Do you allow smoking in the home?

Yes

As a gift