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Name:
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Email Address:
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What is the NAME of the animal for which you are Applying?
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What is the DATE that you are filling out this Application?
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Full Name:
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Full Mailing Address
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Telephone Number
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Work Telephone Number
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Cell Number
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Spouse/Partner's Name
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How Long Have You Lived at the Above Address?
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Do You? Rent? Own? Live with Parents?
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Do You Live In? A House? An Apartment? A Townhouse? A Trailer/Mobile Home?
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(b). If You RENT, Are you Permitted to Own Pet?
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(c). If You RENT, Please provide you LANDLORD's Name and Contact Information.
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Regarding Work, Please Select ALL that Apply.
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Will the Animal be left Alone on a Regular Basis throughout the Week?
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(b). If YES to above question. How long will your pet be left alone Daily?
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When you are at home, WHERE will your pet be during the DAY and NIGHT?
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How many Adults live in your Home?
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How many Children live in your Home? Please list all children's ages.
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Please check ALL that Apply. I want to Adopt a pet for...
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List ALL of the Pets you have owned for the past 10 years.
List: NAME, BREED, MALE/FEMALE, INDOOR/OUTDOOR, SPAYED/NEUTERED, AGE, IF
STILL OWNED (example: Fluffy, Cat, Female, Indoor, Spayed, 8 yrs, yes)
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(b). If you DO NOT still own any of the animals listed
above, please give a brief answer as to why you do not own them and how
long it has been since you owned them.
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What is the Name of the Veterinary Clinic that cares/cared for your pets?
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If any of your pets HAVE NOT been Spayed/Neutered, please indicate why?
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Have your current pets been vaccinated within the last year? If NO, please indicate why?
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Have you had a pet die within the past 3 months from a contagious disease or unknown cause? If YES, please describe.
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Have you Ever Adopted a pet from the Burin Peninsula SPCA? If YES, please let us know if you still own this animal.
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Does Anyone in your Home suffer from Asthma or Other Pet Related Allergies?
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(b). If YES to the above question. How will you handle this
situation? Or if allergies develop within your home what will you do
with your pet?
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If you must MOVE what do you plan to do with your pet?
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What do you intend to do if you go on Vacation, take an
Unscheduled Trip or have a Family Emergency that takes you away from
Home?
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Do you plan to Board/Kennel your pet? If YES, what do you believe will be the cost of this service?
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What do you expect will be the costs of the following: FOOD
(Monthly), VACCINATIONS (yearly), LICENCE (yearly), EMERGENCY MEDICAL
CARE
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What type of ID do you plan to use for your pet?
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Pets need time to adjust to new surrounding. Are you Prepared and Willing to give your new pet ONE MONTH to adjust to your home?
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How Long have you been Planning on Adopting a pet?
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What do you believe is the Life Span of this Animal?
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Do You Intend to Keep this Animal for its Lifetime?
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(a). If you are Applying for a Cat, Your cat will it be an ...
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(b). What will you do if the CAT gets on the Counters?
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(c). What will you do if the CAT scratches the furniture?
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(d). What will you do if the CAT chews on your houseplants?
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(e). What will you do if the CAT messes outside the litter pan?
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(f). What will you do if the CAT keeps you awake at night?
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(g). What will you do if the CAT jumps in the baby's crib?
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(a). If you are Applying for a DOG, Your dog will be an ...
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(b). Do you plan to Tie your DOG Outside? If YES, please indicate for how long.
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(c). How many times a day do you plan to Exercise/Walk you DOG?
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(d). How do you plan to Housetrain your DOG?
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(e). Do you have a Fenced Yard?
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(a). The Burin Peninsula SPCA requires 3 References. References CANNOT be family members. Reference #1: Name & Telephone:
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(b). Reference #2: Name & Telephone:
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(c). Reference #3: Name & Telephone
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How did you find out about this animal up for adoption?
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Animals Adopted from the Burin Peninsula SPCA CANNOT be sold
or given a new home without notifying and gaining permission of the
SPCA. Do You Agree to these Terms?
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