Pet interested in:
Adopter:
First Name
MI
Last Name
Date of Birth
Spouse/ Other Adult in Household:
First Name
MI
Last Name
Date of Birth
Address (No P.O. Box)
City
County
State
Zip
Home Phone
Alternate phone
Email
How many adults in your home?
How many children in your home?
Ages?
Do you own your home?
Please provide landlord first and last name, and phone number
Landlord
Phone number
*Please note that we do confirm home ownership or obtain landlord approval for ALL potential adopters*
Have you ever adopted from a shelter or humane society?
Where?
Have you ever been refused adoption from a shelter or humane society?
Where?
Have you ever taken an animal to a shelter or humane society?
Why?
Please list any pets you've owned in the last five years.
Name
BreedIndoor/Outdoor AgeSexAlteredStill Own?Why not?
BreedIndoor/Outdoor AgeSexAlteredStill Own?Why not?Veterinarian
Phone number
Have you ever been convicted of a crime (other than traffic violations or civil judgments)?
Please describe
By signing this agreement, I certify that the information I have given is true, and I recognize that any misrepresentation of the facts may result in my losing the privilege of adopting a pet. I understand that Green Lake Area Animal Shelter, Ltd. has the right to deny my request to adopt an animal. I understand that this information could be made available to other shelters. This form will become the property of Green Lake Area Animal Shelter, Ltd.
Signature of Applicant
Date
Time
DOG ADOPTION QUESTIONNAIRE
Who will be the primary caregiver for this dog, responsible for feeding, grooming, exercising, training, and clean up?
How much time are you prepared to allow your new pet to adjust to its new home?
How many hours per day will this dog spend alone?
How many hours per day will this dog spend outside?
Where will the dog be kept when you're not home and/or at night?
Please describe your available yard space.
Are you familiar with the needs and characteristics of the breed you've chosen? Please describe.
What type of food and feeding schedule do you plan to use?
What is the worst behavior problem a dog could have, and how will you address training or behavior problems? Who will you call for assistance?
Do you want this dog to:
How much do you think you'll spend per year on the care of this pet, including food, routine or emergency medical care, toys, etc.?
If you have other pets, how will you handle introductions or fights between them?
If you move or become unable to care for your new dog, are you willing to return him/her to the Green Lake Area Animal Shelter?
CAT ADOPTION QUESTIONNAIRE
Who will be the primary caregiver for this cat, responsible for feeding, grooming, exercising, training, and clean up?
How much time are you prepared to allow your new pet to adjust to its new home?
How much do you think you'll spend per year on the care of this pet, including food, routine or emergency medical care, toys, etc.?
If you have other pets, how will you handle introductions or fights between them?
If you move or become unable to care for your new cat, are you willing to return him/her to the Green Lake Area Animal Shelter?
Please describe your litterbox set-up and placement.
Are you aware that you should have the same number of litterboxes as cats, plus one, and that they should all be in seperate locations?
If you have cats now, do they all use the litterbox consistently without accidents?
Will you let your cat outdoors?
What characteristic is it most important for this cat to have? Examples: Playful, Friendly, Calm, Quiet, Clean, Independent
What type of food and feeding schedule do you plan to use?
Do you plan to declaw your cat?
Are you aware of the possible effects?
If you are, what is your reason for proceeding with the declaw?
Are you interested in training your cat to use a scratching post?
What is the worst behavior problem a cat could have, and how will you address training or behavior problems? Who will you call for assistance?
Thank you for your interest in giving a homeless pet a new life!
Processing your application usually takes less than a day. However, in order for your application to be processed, it must be fully completed. Please make sure to fill in your landlord contact and veterinary information, as well as the name or id# of the pet you are interested in. Without this information, we cannot send you home with your new family member! We look forward to hearing from you!
