Adoption Application Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Employer * License # * Spouse's / Partner's Occupation Do you own or rent your home? * if you rent, does your landlord allow pets? Yes No Landlord's Name Landlord's Phone # Pet Information / Pet Plan Name of pet in which you are interested? Our adoption fees vary based on adopt ability in order to help all animals in our program. Did you see the specific adoption fee for the dog you are interested in adopting? * Yes No What is the adoption fee for the pet? For whom is the animal being adopted? * Are all adults that live in this household familiar and agree that it is acceptable to adopt an animal? * Yes No Who will be responsible for the care of this animal? * Where will the animal stay during the day? * Where will the animal stay during the night? * Approximately how mant hours will your animal be alone each day? * What arrangements will you have for exercise and toilet duties, etc.? * Are there children living in the home or that visit often? * Yes No Ages? Have you ever adopted from us? * Yes No If yes, do you still have the animal? Yes No If no, please explain Are you willing to have one of our reps visit your home prior to adoption? * Yes No Have you ever received training with any previous dogs? * Yes No If necessary, are you willing to pay for professional training (starting at $120-$250)? * Yes No Does anyone in your household or who regularly visits have pet allergies? * Yes No Dog specific - Do you have a safe enclosed fenced yard? * Yes No Are you going on vacation or moving within the next three to four weeks? * Yes No Do you currently have other pets? * Yes No If yes, how many do you currently have? Are they indoor or outdoor pets? Indoor Outdoor Please list all your current animals here with their breed and age. Have you had an animal die on your premises in the last year? * Yes No Have you ever taken an animal you owned to a shelter or animal control? * Yes No If yes, how many and why? Are all of your current animals spayed/neutered? Yes No Are all of your pets current on vaccines? Yes No Do you provide your pets with flea/tick prevention? Yes No Do you provide your pets with heartworm prevention? Yes No Are you aware that heartworm disease is prevalent in the south and dogs living in or adopted from the south need to be on heartworm prevention year round or they most likely will contract heartworm disease? * Yes No Are you aware that heartworm disease is fatal if left untreated? * Yes No Are you aware that it costs approximately $20 per month for heartworm prevention, but it can cost between $450-$1,000 to treat heartworm disease? * Yes No Dogs will continue to require veterinary care, heartworm prevention, checkups, and sometimes medicine to keep them healthy. Are you prepared to provide the necessary time and financial resources to care appropriately for your pet? * Yes No Are you willing and able to care for this animal its entire life which could be as much as 15 years? * Yes No Are you willing and financially able, to provide urgent and/or emergency veterinary care in case your pet gets sick or injured? * Yes No Do you agree to contact the rescue in the event that you can no longer keep this pet, and agree NOT to re-home, give away, or sell this pet, nor surrender this pet to a shelter? * Yes No I understand that I am required to pay an adoption fee and sign a contract for care. * Yes No Please provide. aveterinary reference * Must include clinic name, vet name, and phone number What is the name of the closest emergency vet to your home? * I certify that the above information is true and accurate and that all information will be verified. I understand that Trooper's Treasures reserves the right to reject any application. I understand that the information entered hereon will only be used by Trooper's Treasures and will remain confidential. * Yes No I understand that Trooper's Treasures may impound my animal if the animal I adopt from them is not in compliance with the adoption requirements or it does not have food, shelter, water, or is tied out, or is in a kennel that is not attached to the house. * Yes No Please enter your full name below to serve as your electronic signature * By signing this I agree to all of the above terms First Name Last Name Today's Date * MM DD YYYY Thank you!
