Northern Animal Rescue Adoption Application Form

Name or description of dog / cat you are interested in adopting:

Why do I have to apply to adopt an animal?

Many of our animals are in foster care because their former owners did not think through the responsibilities of owning a pet. We request that all potential adopters fill out this form so we can ensure your decisions to adopt a pet are not based on an emotional response. We see many pets that were purchased or obtained as a novelty, become a burden to their family, then often forgotten or mistreated. This information will help us to ensure that you will provide an excellent home for one of our animals. We appreciate your cooperation.

Applicant's Information:

First Name:

Last Name:

Address:

Phone Number:

Email Address:

1. Do you rent or own your home?

Rent

Own

If you rent, do you have permission from your landlord?

Yes

No

Landlord's name and phone number:

2. Number of Adults and Children in the home and their ages?

3. Does anyone in the home have allergies of any kind?

Applicant's History & Care Plan:

4. Have you had animals in the past that are no longer with you?

Yes

No

If yes, explain what happended to them:

5. Who will care for the animal if you cannot? (vacation, illness, etc.):

6. What does a typical weekday look like for the animal(s) in your home? Include sleeping arrangements, wake-up time, potty breaks, meals, exercise and what times they will be alone or with you.

7. What will you do if the animal shows unacceptable or destructive behavior? (Chewing, barking, digging, biting, messing inside, etc.):

8. What experience do you have training puppies or dogs? Are you able and willing to take them to a certified trainer if needed?

9. Do you have a fenced yard?

Yes

No

10. Please describe the expected grooming requirements of this animal. Are you okay with shedding?

11. Do you understand that all of our information about this animal is based on observation of the animal by their foster families and veterinarian?

Yes

No

12. Please detail all pets in the home with their breed, age, sex, current vaccines and if they are spayed/neutered:

Current vet's name:

Clinic:

Clinic's Phone Number:

Number of years a client:

Do you give us permission to contact your vet in regard to the pet you are adopting from NAR & the vaccine and spay/neuter status of current animal(s)?

Yes

No

By signing this form, you certify that all information provided to us in this form is true. You give permission to Northern Animal Rescue to verify as needed. You also understand that a home check may be required before adopting a pet.

Yes

No

Do you understand any FALSE information will terminate the potential adoption?

Yes

No

Potential Adoptive Person's Signature:

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Date

Year

Month

Day

PERSONAL REFERENCE: (other than a family member)

Name:

Phone Number:

Witness Signature:

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Date

Year

Month

Day

If the adoptive pet requires a spay or neuter, this procedure will be completed no later than six months or a confirmed appointment has been scheduled and a follow up appointment will be scheduled within a month of the above-mentioned date. Proof of spay or neuter is required to be submitted to NAR to close the animal's file.