506B Curtis Corner Road, Peace Dale 02883 PO Box 458, Wakefield RI 02880-0458 (401) 783-7606 APPLICATION FOR ADOPTION Name of Spouse/Partner: __________________________________________________________ Street Address: __________________________________________________________________ City: ____________________________________________ State: ________ Zip: _____________ Mailing Address: _________________________________________________________________ City: ____________________________________________ State: ________ Zip: _____________ Home Phone: ____________________________ Work Phone: ____________________________ Place of Employment: _____________________________________________________________ Spouse/Partner's Place of Employment: ______________________________________________ Driver's License #: _______________________________ State: ________ DOB: _____________ 1. Do you have any children? _________ How many and what ages? _______________________ 2. Name, address, and number of past and present veterinarians: __________________________ ________________________________________________________________________________ 3. Do you plan to spay or neuter? _________ Why? _____________________________________ 4. Are you aware that millions of cats and dogs are euthanized each year due to over population, neglect, abuse, and improper care? __________________________________________________ 5. Please check type of residence: [ ] Owned home [ ] Owned condominium [ ] Rented home [ ] Rented apartment [ ] Rented condo [ ] Dormitory [ ] Mobile home [ ] Live with parents [ ] Fraternity [ ] Sorority [ ] Live with grandparents [ ] Other arrangements: ___________________ 6. How long have you lived at this address? ____________________________________________ Do you plan on moving in the next 6-12 months? ______ Explain: _______________________ Please list your addresses for the past 5 years: ______________________________________ If you are renting or living at home with parents/guardian, it will be necessary to confirm permission for adoption. Please provide information about your parent, guardian, or landlord. You may be required to show a current lease agreement, also. Parent/guardian/landlord name: ______________________________ Phone #: _______________ Address: ________________________________________________________________________ 7. Have you adopted from the Animal Rescue League before? _____________________________ If yes, when? _____________________________ Still have the animal? ___________________ 8. Have you ever had to turn an animal into a shelter and for what reasons? __________________ ________________________________________________________________________________ 9. Please provide the following information about any pets currently living in your household:
10. Is this your first experience adopting a dog or a cat? [ ] Yes [ ] No 11. Why would you like to adopt a pet? _______________________________________________ 12. Would you be interested in borrowing books/videos on training or caring for this animal? [ ] Yes [ ] No [ ] Maybe 13. The expense of owning a pet can vary greatly depending on the individual animal's need and your lifestyle. Costs include regular and emergency veterinary care, medications, food, training, flea control, grooming, boarding, etc. To help us recommend the right pet for you, please indicate how much you can comfortably afford to spend each year on an animal: 14. Anyone in your household allergic to animals? _______________________________________ I understand that misrepresentation or omission of facts on this application is cause for denial of adoption. I authorize investigation of all statements contained in this application. I understand the Animal Rescue League has the right to deny any application for whatever reason. I understand that the shelter animals may have unknown medical backgrounds and the Animal Rescue League cannot guarantee the health and behavior characteristics of adopted animals. Signature: ___________________________________________ Date: ___________________ |