Adoption Application

Name of Animal

Species of the Animal

Adopters First and Last Name

Phone Number

Street Address

City, State and Zip Code

Mailing Address (if different)

What type of home do you live in? (Apartment, Rent House, Own Home, Other)

Can you provide proof of pet deposit required if rent?

Do you have a fenced-in area? If so, how large is it?

How did you hear about APET?

What pets do you currently have?

List your current pets with breed and sex.

Are your current pets up to date on shots?

Are your pets spayed and neutered?

What kind of Heartworm preventative?

If you have children list them with ages.

Name and phone number of your veterinarian:

Have you given up a pet previously? Yes / No If so, please explain:

I certify that I have answered all questions honestly and to the best of my ability. I understand that any misrepresentations of facts may result in the adopted pet being removed from my home.

By adding my name I understand that it represents my signature.