Animal of Interest
About You
Name *
Name
Phone *
Phone
Address *
Address
Name of current Veterinarian
Name of current Veterinarian
Veterinarian's phone number
Veterinarian's phone number
Housing Information
Landlord\Apt. complex Phone Number: (Required if Renting)
Landlord\Apt. complex Phone Number: (Required if Renting)
Is there a breed ban in the area you currently live? *
Is your yard fenced?
Pet Fit Questionnaire
Are these Pets: Spayed/Neutered?
Vaccinated?
Is anyone in your home allergic to dogs and or cats:
Is this pet a gift?
Please select the reason(s) why you want to adopt a pet at this point in your life:
Pet Care Questionnaire
Do you plan to declaw the pet?
Do you plan on making any cosmetic alterations to the pet? (Such as ear cropping or tail docking)
If the pet you wish to adopt is under the age of 1, are you familiar with pet proofing the house?
This includes, but is not limited to: tucking electrical cords/confining them within plastic cord protectors, keeping dangerous chemicals out of reach, screening windows tightly, keeping trash cans out of reach, securing potentially dangerous furniture or decorations, etc.)
When you are out of town, you plan to:
If you had to move, you would:
What would cause you to return this pet – please check all that apply:
Agreement
You agree to allow All Valley Animal Rescue to visit your home by appointment as part of our application process:
All of the information I/we provided in this application is true and correct. I understand that submission of this application does not guarantee I will be selected to adopt this animal(s). *
All of the information I/we provided in this application is true and correct. I understand that submission of this application does not guarantee I will be selected to adopt this animal(s).
*