Thank you for adopting. Recently, we have had an overwhelming number of applications. We have a $10 application fee which helps to cover our administrative expenses of processing. The application fee is non-refundable. We do ask what pet you are interested in; BUT please note we cannot guarantee that pet will still be available once you are approved. Once approved your application is good for six months and you will have a meet and greet with pets we do have available at that time. We will do our very best to match you with a pet. Please feel free to call us or email us for the status of your application if you do not hear back within 48-72 hours. 603-635-4495 or . email@example.com Total
Credit Card * Applicant Name: *
How did you hear about us? Home Phone Cell Phone Email * Employer: Occupation: What type of pet are you interested in? Age of pet interested in? Name of pet you are interested in: Personality type: Other Preferences: How many people currently reside in your household? Any children in the household? None 1 2 3 4 5 6 7 8 9 10 For Whom are you adopting the pet Does any member of of the family have allergies to animals? Yes No If yes, explain: Who will be responsible for the pet's care? Where do you live? Apartment Condo Farm Mobile Home Townhouse House Do you own or rent your residence? Own Rent If you rent, what is name of landlord and phone number? If you own, we require proof of home ownership, which can be a tax bill or proof of purchase. Please upload below. Accepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.
A tax bill or proof of purchase. If your attachment is too big, please email it to firstname.lastname@example.org
Are pets allowed? Yes No Not Sure Where will the pet be kept? Indoors only Outdoors only Both in/out If outdoors will pet be? attended unattended collar and tags? Will anyone be home during the day? Yes No How many hours will the pet be left unattended? When no one is home, where will the pet be kept? Do you have a fenced yard? Yes No Of adopting a cat, do you plan to declaw? If you move, what will you do with the pet? How far from the road/traffic is you home/farm located? What is the volume of traffic? Light Moderate Heavy Have you ever had a pet before? Yes No Describe the pets you still care for or that you have had in the last 5 years. If the animal is no longer in your care, please explain: Are your pets current on their vaccinations? Yes No Please provide name of your veterinarian: Veterinarian Phone number: Personal References: Are you financially able and willing to provide annual checkups, vaccinations, and ANY medical care necessary? (Pets can live upwards of 15 years.) Yes No What precautions would you take to properly introduce a new pet into your home if you have other animals (a dog, bird, rabbit, cat, etc.)? What will you do if your new pet does not get along with your present pets? Have you ever adopted an animal from a rescue/animal control agency? Yes No Why do you want to adopt a pet? Are you familiar with your local animal control laws? Yes No Are you willing to sign legal pet adoption papers? Yes No Do you agree to permit a visit to your home/farm by appointment? Yes No Under which circumstances would you give your pet away or surrender to a shelter? If not listed, please indicate under ''Other''. Not Obedient Enough Illness in family Pet became ill Moving New Baby Shedding too much Barking Chewing Too energetic Doesn’t get along with other dogs Divorce Got a new pet Allergies Housetraining problem Bit Someone Kids ignore pet Pets not getting along Got too old Doesn’t like all people Would not give pet away at all Pets on furniture Other Have you ever surrendered a pet to a shelter? If yes, why? By submitting this form, I/we acknowledge that all information on this form is true and correct. I/we
understand that any misrepresentation of fact may result in Darbster Foundation refusing
adoption privileges to me/us. If my/our request for adoption is approved and later Darbster
Foundation discovers the above information is not true or correct, Darbster Foundation reserves
the right to remove the adopted cat from my home.
If you have exhausted all reasonable efforts to keep your pet, Darbster Foundation accepts the
return of any animal adopted from our facility. Adoption returns must be scheduled in advance
and are accepted by appointment only. Guardians who wish to return their adopted animal should
call 603-856-9233 or email email@example.com to schedule an appointment. Note- there will
be an intake fee of $100 if returned after 14 days from the original adoption date. Signature Date
MM slash DD slash YYYY
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