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Adopting A Friend
Adopt ME Society Adoption Application
Please fill out the following questionnaire to help us find the right companion match for you.
Name(s):__________________________________
Address: ______________________________________
City: ______________ State: _________ Zip: _________
Home Phone: _________________ Cell: _____________ Work: _____________ Email____________________________________________________________
What type pet are you looking for: _______Dog _________Cat_________ Dog/Cat?
Is this pet for: ___________You ____________Family ____________ Another Person
Why do you want a pet? ______________________________________________________________
Explain what you are looking for in a pet? ________________________________________ _______________________________________________________________________
Size: (Dog Adoptions) ____Small up to 30 pounds ____Medium 40-70 pounds ____Large 80-100 pounds
___ Huge over 100 pounds _____ Any size is OK ____ Depends on Dogs
Breed: I am looking for the following breed(s)
Activity Level: ____ Low____ Medium _____ High
Age: ___8wks-3 mos ___ 3-6mos ___ 6-18mos ___8mos – 3 yrs ___ 4-6 yrs ___ Any age is OK
How many people live in your home? _____
List Names and Relationships:
Names: Relationships Age
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Do children or grandchildren visit on occasion’s _____ Yes/Ages: _____/ ____No
Is any one in your home allergic to any pets? ____No ____ Yes ___Don‘t Know
Does your home have a yard: ___ Yes ___ Fenced ___ Not fenced ___ No yard
Your household is ___ Quiet ___ Active ___ Very Active
Do you: ___ Own ____ Rent ____ Live with parents
Does your landlord allow pets? ________
Please list your landlords name and phone. ______________________________________________________________________________________
Where will you keep your pet during the day? _____Inside ____ Outside _____Inside/outside
At night: _____Inside ____ Outside _____Inside/outside
How many hours in a day will your pet be home alone:
____ Somebody is usually always home____ 1-4 hours ____ 8-12 hours ___ I come home during lunch
____ I bring my pet to work with me _____ I plan on using doggie day care ____ I have a doggie Door
The pet I adopt must (check all that apply) ___ Do well with children ____ Do well with dogs
___ Do well with cats ___ Do well with strangers
I’m prepared to train my new pet for __ Housebreaking __ Destructive chewing __ Separation anxiety
Who will be your new pet(s) primary caretaker: __________________________________________
I am willing to spend up to the following amount for treatment of a pet: ___ $0-$50 __$51-$100
__$101-$250 __ $251-$500 ___ Whatever the animal needs.
Your Pet History
Please provide a list of current and past animals. Include type and ages, how long you had them, where did you get them and why they’re no longer with you.
Pets name Breed Age Adopted from with you/why not with you
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Are they current on vaccinations (including rabies) ___Yes ___ No
Are they spayed or neutered ____ Yes ___ No
Are they licensed __yes __ no
Under what circumstances would you give up a pet? _________________________________________
Have you ever had to give up a pet? If yes tell us why and what did you do.
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Name of your veterinarian: ______________________________________________________________
Sign _______________________________________________________ Date __________________
ADOPT ME SOCIETY
Daye Abbott 801-209-6130
Amy Kreitzer 801-910-9233
Stacie Turner 801-243-6896
Who We Are
Adopt ME Society is a 501(c)(3) Non-profit organization run by volunteers whose shared goal is to rescue, provide sanctuary and ultimately to re-home abandoned, stray and neglected animals.
Come Visit Us
Pets Mart 389 West 1830 South SLC -1St weekend From 12- 4 Sat/Sun
Pets Mart 389 West 1830 South SLC -2nd weekend From 12- 4 Sat/Sun
Dog Meow 2047 East 3300 South SLC -3rd weekend From 12 -4 Saturday Only
Pets Mart 5748 S Redwood Rd Taylorsville -4th weekend From 12 -4 Sat/Sun
