E-mail questions, comments, or suggestions to:firstname.lastname@example.org
Adopting a friend
To transfer application to new email: Left click and highlight application. Then right click and hit copy, then go to new email and right click on it and hit paste. Then fill out application and email it back to us Name__________________________________________________________________________________ Address_______________________________________________________________________________________ City_________________________ State______ Zip__________________ E-Mail Address________________________________________________ HomePhone__________________CellPhone____________________Work Phone___________________ Type Of Residence: (a) House (b) Apartment (c ) Condo (d) Mobile If Rental, are pets allowed? Y/N Are there any restrictions? Y/N Number of pets allowed?______ Is there any pet deposit required? Y/N If yes, how much? ___________ Apartment Complex or Landlord’s Name ________________________________________________________ Current Housing Location ________________ Within City Limits? Y/N Outside City Limits Y/N Type of street (a) Very busy (b) Slight traffic (c ) Country, off main road (d) Residential Neighborhood (e) Mobile Home Park Where will the pet live? (a) Inside Only (b) Mostly Inside (c ) Outside Only (d) Mostly outside Facilities for pet (a) Fenced yard if so, what type of fencing?____________________ How high is it?______________ (b) Fenced run/ pen? Size of pen__________ (c ) Runner (d) Leash walk (d) Tethered Chain (f) Other____________ Will you allow your pet to run loose unsupervised? Y/N Hours per day pet will be left alone ________ Where will your pet when left alone? _________________________________________________________________________ Are you willing to obedience train your pet? Y/N Age group of applicant (a) 18 & under (b) 19– 29 (c ) 30 - 60 (d) over 60 Are you (a) Employed (b) Retired (c ) Student (d) Homemaker (e) Unemployed Employer _____________________________________________________________________________________ Number Of people in family ______ If children are in the home list ages ____________________________________ Do you currently have pets? Y/N How Many? ________ If so, please list Type/ Breed__________________________ ______________________________________ Are they spayed or neutered? Y/N If you currently do not have a pet, have you ever and if so what happened to them? ______________________________________________________________________________________________ How long ago? __________ Type/Breed_____________________________________________________________ What happened to them? _________________________________________________________________________ Please list current or past veterinarians and phone# _______________________________________________________________ Why do you want a pet?__________________________________________________________________________ Do you consider you pet as part of the family? Y/N Are you aware that a pet is a large responsibility? Y/N Will you have you pet spayed or neutered? Y/N Can you afford to pay veterinary bills if you pet should become sick or injured? Y/N Is anyone in the home allergic to animals? ________________________________________________________________________________
Come Visit Us!
Our new adoption center is located across the street from the Fairfield County Recreation Center on US Highway 321 Business behind the Midlands Tech Trade School
Fairfield County Animal Adoption Center 1678 US Highway 321 Business