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Adoption Application
* indicate required information
Pet Name (if applicable) or type interested in:
Animal Adopting - Your selection will send the application to the correct adoption team.
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Puppy/Kitten
Adult Dog
Senior Dog
Adopters and Adult Residents in House
Please include ALL adults - spouse, partner, roommates, children 18+, friends, parents, etc.
Primary Adopter - Name
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First
Last
Phone
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Email
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Place of Employment
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Age
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How did you hear about Save-A-Mutt?
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Do you currently have applications submitted to other rescue organizations for a pet?
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Yes
No
Do other adults (18+) live in the home either part time or full time?
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Yes
No
Please list all other adults (age 18+). Use 'plus sign' to add additional adults.
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Full Name
Email
Phone
Place of Employment
Relationship
Age
Add
Remove
Home Information
Home Address (where pet will be living)
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Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Home Type
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House
Condominium
Apartment
Other Rental
Home Status
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Own
Rent
Live with someone
Are pets allowed?
Yes
No
Landlord Information
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Landlord Full Name
Landlord Phone or Email Address
By providing this information, you acknowledge that we will be contacting your landlord.
How long have you lived at your current address?
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Many adoptable dogs are ready to go home within a few days of application approval, especially Puppies. Do you have any upcoming travel or 'out of town' plans that will limit your timeframe for adopting? Process time from start to finish on your application, can be as little as 2-5 days.
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Yes
No
Have you or anyone in your home been charged / convicted of a crime involving an animal?
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Yes
No
What are your plans? Do you feel it will affect your new dog?
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For what reason(s) would your return your adopted pet?
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Do you have children living or visiting the home?
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Yes
No
Children Information
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How Many / Relationship?
Ages?
Are you children used to animals?
Yes
No
Is anyone living in the house allergic to animals?
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Yes
No
Do all adult members of the household know you plan to adopt a pet?
Yes
No
Pet Lifestyle
Why do you want to adopt this animal?
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Companion
Companion for Kids
Companion for other Pet(s)
Guard/Watch Dog
Hunting Dog
Gift / Present
Other
Please check all that apply.
You selected "other" please elaborate
For DOGS - when this dog is outside, it will primarily be:
In a Fenced Yard
On a Leash
Allowed to Run Free
Tied Up/Trolley
Other
For DOGS - If the yard is fenced, will it safely CONTAIN the dog?
Yes
No
Fence Details
Type of Fence
Height of Fence
Add
Remove
What type of outside shelter will be provided?
For DOGS - Are you willing to enroll the dog in an obedience class?
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Yes
No
What type of activities do you foresee doing with your pet?
Would you allow our representative to do a home check prior to adoption?
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Yes
No
Pet Care and Wellness
List ALL pets (Current / Deceased / Rehomed) that you have had in the last 7 years. List any roommate pets if applicable. Use 'plus sign' to add additional pets.
Name
Breed / Type
Age
Gender
Spayed/Neutered?
Current Status
Add
Remove
Are all of your pets current on their vaccinations?
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Yes
No
Do you currently have a veterinarian?
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Yes
No
Veterinarian Information
Name
Phone Number
By providing this information, you acknowledge that we will be contacting your veterinarian. PLEASE contact your vet office and give permission for us to talk to them.
How much approximately are you willing to spend on vet bills per year? How will you financially handle medical emergency? NUMBER ONLY
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Are you willing to obtain pet insurance for your new pet?
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Yes
No
How many hours pers day will the pet be alone (without HUMAN companionship)? This is while at work, errands, etc.
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Where will the pet stay during the day?
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Where will the pet stay during the night?
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Will this pet primarily live indoors?
Yes
No
References
Please use references with EMAIL addresses ONLY. It is our preferred form of communication. We are looking for people that can comment to your ability to take care of an adopted animal, perhaps previous experience, etc. WE WILL NOT move forward with your application if you leave references blank. We treat each application with confidentiality - and References are valuable part of our process.
Reference Information
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Name
E-Mail Address
Relationship Type
Add
Remove
Reference Information
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Name
E-Mail Address
Relationship Type
Add
Remove
Reference Information
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Name
E-Mail Address
Relationship Type
Add
Remove
Is there any other information you would like us to know? Previous pet history, more detail to above answers. Anything you want us to know in regards to adopting from Save-A-Mutt?
Signature and Legal Information
By signing below, I certify that the information I have given is true and that any misrepresentation of facts may result in my losing the privilege of adopting a companion animal from Save-A-Mutt. This pet will reside in my home as a companion animal. I will provide it with adequate food, water, shelter, training, affection and medical care. I am in full agreement with these terms of adoption. Save-A-Mutt is in no way liable or responsible for any damage, accident or injury resulting from the placement of a pet in my household. Thank You.
Signature
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