KC Rescue Adoption Application

Date: 

APPLYING FOR:
Name of Animal:	
Description:	
WHERE DID YOU SEE THIS PET POSTED:
Petfinder.com:       1-800-.com:        Other<Please esplain>:
APPLICANT'S INFORMATION:

Full Name:	
If Co-owned:
Address:	
City:	
State:	
Phone Number:	
E-mail address:	
Place<s> of Employment:
HOUSEHOLD INFORMATION:

Where Do You Live? 
House
Condo/Apt.
Mobile Home
Student Housing
Military Housing

Neighborhood?:  
City
Suburbs
Rural

How long at your present address?	
Do You Own Your Own Home? 
Are you planning to move within the next year?
If you decide to move in the future, what will you do with your companion animal?

How many adults in your home?	Ages?
Are there children in your home?            
If yes, how many and what are their ages? 
Are all members of your household aware of your plans to adopt an animal? 
Are any members of your household allergic to animals? 
Where will your companion animal sleep?	
How many hours will your companion animal be alone? 
Who will be responsible for the animal? 

VACATION:
How often do you go on vacation? 
What will you do with your companion animal when you go on vacation?

EMPLOYMENT:
Employer: 
Occupation: 
How long at your present job? 
Can you be contacted at your job? 
If yes, work phone #: 


OTHER ANIMALS:
Do you have cats? 
If yes, how many? 	Do the cats live strictly indoors? 
Are cats declawed? 
Do you have dogs? 
If yes, how many? 	Do dogs live indoors? 
Other animals?
Are all animals in your household spayed/neutered? 
Are your dog<s> on monthly heart worm preventative? 

The following info is very important in my adoption process; if you don't have/have not had a vet please explain 
below: 

Your Veterinarian: 
Phone number:
Address: 

Because our fosters are situated in different locations, are you willing to travel a distance to meet your dog if the application is approved?

QUESTIONS: (Use back of application to answer)
Why do you want to adopt an animal? 
What type of personality are you looking for? 
(If applicable) Have you ever had a special needs animal before? 
If necessary, how will you discipline the animal? 
Comments:


I hereby certify that all information supplied by me on this application is true.

Signature: 
Date: