Application for Adoption

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We ask that you fill out this application completely. It is designed to help you find the companion most compatible with your lifestyle. Our ultimate goal is to match the right dog with the right new home. Pet ownership is a serious responsibility. The adoption process is to assure that each person who adopts a pet is aware of the responsibility, and that each is capable and willing to accept that responsibility morally, physically and financially.

This questionnaire has been designed to aid both you and the sanctuary in deciding if you and /or your family are adequately prepared to assume the type of responsible ownership we are attempting to assure for our adopted animals. Please take the time to read the adoption procedures carefully. If you have any questions during the application process please feel free to contact us.

Date:
Name: *
Address: *
City: *
State: *
Zip:
Phone Number: *
Email Address: *
Best Way to Contact You:
Pet you are interested in:
Marital Status:
Number if Adults in the home:
Number of Children in the home:
Ages of Children:
Do you rent or own:
Do you have a fenced in yard?:
If Renting, please provide Landlords name & phone number:
House/Apartment/Condo/Townhome/Mobile Home:
Employer:
Where will your pet be kept during the day?:
Where will your pet be kept at night?:
On average, how many hours a day will pet be home alone?:
Who will care for pet if you go on vacation?:
Do you have someone to care for your pet in case of emergency?:
Is anyone in your home allergic to pets? If yes, what kind?:
Is this pet a gift for someone else?:
Under what conditions would you not keep your new pet?:
What would you do with pet in the event that you couldn't keep it?:
Have you ever turned a pet over to a sanctuary, rescue, animal control or humane society before? If yes, why?:
Are you willing to allow a home visit/check?:
Please tell us about any pets you currently have living in home:
Are all other pets current on vaccines?:
Are all other pets spayed / neutered?:
Name of Veterinarian:
Name of Clinic:
Phone Number:
How did you hear about E.A.R.S.?: *
Note: An adoption may be denied for your failure to have all pets in your household spayed/neutered...remember our goal is...NO MORE HOMELESS PETS