Adoption Application

First Name

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Last Name

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Springfield

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State

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Zip Code

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Adoption Application

Which dog are you most interested in adopting?

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Another dog you are also interested in adopting.

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Employer

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Employer Phone

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In what type of home do you live?

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Do you own or rent your home?

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If you rent, provide your Landlord's name and phone number

Landlord's Name

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Landlord's Phone Number

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If you have an HOA, provide your a contact name and phone number

HOA Contact Name

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HOA Contact Number

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Any pet restrictions?

Do you:

Work Outside the Home

Attend School

Work at Home

Is anyone home during the day?

Yes

How many hours wlll your pet without human companionship?

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Do you have a fenced yard?

Yes

No Yard

What type of fence do you have?

Chain-Link

Privacy

Invisible

What is the height of your fence in feet?

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Please Read Carefully:

Adopting a pet is a serious responsibility. A dog or cat you adopt today will likely be a part of your family for the next 10 to 15 years. Each pet has its own personality and preferences that you can help shape through love and conscientious training.

A dog makes considerable demands on your time and resources. Dog owners need to spend time walking, grooming, training, and playing with their pets every day. Certain breeds may require professional grooming.

A cat requires quality time each day with its family and maintenance such as litter box cleaning, feeding, petting and brushing.

Cats and dogs require special food and regular veterinary care. This includes annual shots and MONTHLY PREVENTIVE MEDICATIONS FOR HEARTWORM AND FLEAS. In some cases, these expenses can exceed $1000 a year.

Are you prepared to accept the financial and personal responsibility for a pet?

Yes

A volunteer from Justin Bartlett Animal Rescue may follow-up with you and your pet by visiting you in your home or by talking with you over the phone. We would visit your residence by appointment only. Would you have any objection?*

Yes

"Dogs are not our whole life, but they make our lives whole."
–Roger Caras