Adopt

First Name

Last Name

Email Address

Phone

Alternate Phone

Street Address

City

State StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasU.S. Virgin IslandsUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

How old are you?

Occupation

What type of animal are you interested in adopting? What type of animal are you interested in adopting? Cat Dog

Please list the names (first and last) and ages of the people that live with you.

Home Type Home TypeHouseMobile HomeCondoRental Property

Do you own your property? Do you own your property? Yes No

Name of Mobile Park

Phone Number of Mobile Park

Name of Landlord

Phone Number of Landlord

Do you have fenced-in yard? Do you have fenced-in yard? Yes No

Please list fence type and height.

Please provide the contact information for the VET CLINIC(S) that can verify the vaccination and spay/ neuter status of your current pets. Please provide the names that the records may be found under.

Which of our dogs are you interested in?

Which of our cats/ kittens are you interested in?

The cat/kitten will be The cat/kitten will be Indoor only Inside and outside Outside only

What is it about this dog(s) that appeals to you?

If the dog(s) you are interested in are no longer available, should we continue to process your application so that you can be pre-approved for any future dogs we may have? If the dog(s) you are interested in are no longer available, should we continue to process your application so that you can be pre-approved for any future dogs we may have? Yes No

An animal requires routine vet care of (not limited to) a yearly vet exam and yearly vaccinations. Will you provide this? An animal requires routine vet care of (not limited to) a yearly vet exam and yearly vaccinations. Will you provide this? Yes No

Are you prepared to pay for the yearly expenses for a cat? This includes things like litter, food, veterinary expenses, etc. Are you prepared to pay for the yearly expenses for a cat? This includes things like litter, food, veterinary expenses, etc. Yes No

If applicable, do you agree to have the dog you adopt spayed or neutered within one month of adoption or when the dog is 6 months old? And are you willing to provide PRL proof in the form of a receipt from the vet? If applicable, do you agree to have the dog you adopt spayed or neutered within one month of adoption or when the dog is 6 months old? And are you willing to provide PRL proof in the form of a receipt from the vet? Yes No

Do you agree to have the kitten you adopt spayed/ neutered by the time it is 6 months old? Will you provide proof in the form of a receipt to PRL? Do you agree to have the kitten you adopt spayed/ neutered by the time it is 6 months old? Will you provide proof in the form of a receipt to PRL? Yes No

All new cats/kittens and exisiting pets need time (weeks to months) to adjust to the new changes. An adult/ older cat even more so. Are you willing to give them that extra time and help them with the transition? All new cats/kittens and exisiting pets need time (weeks to months) to adjust to the new changes. An adult/ older cat even more so. Are you willing to give them that extra time and help them with the transition? Yes No

Are there any dogs or cats (indoor/ outdoor) currently living at your residence? Are there any dogs or cats (indoor/ outdoor) currently living at your residence? Yes No

Have you ever given away, lost, sold, abandoned, surrendered, or mistreated an animal? If yes, please explain.

What conditions or circumstances would cause you to give up a pet?

What would you do if your new dog has an accident in your home? What actions would you take to correct the behavior?

Please explain the longest amount of time your dog will be left alone at any given time.

Where will your dog be when everyone has left the house? Where will your dog be when everyone has left the house?Loose in house when comfortableIn crate or kennelIn garageOutsideOther

How will your dog be exercised and how often?

Are you willing to work with your dog on any issues it may have? Are you willing to work with your dog on any issues it may have? Yes No

How long do you feel a new pet and your other pets should be given for an adjustment period?

Are you willing to have a PRL rescue do a home visit? Distance is a factor in whether or not the required home visit can be completed, but we will do our best to accommodate. The home visit gives us the chance to visit with you and make sure your home is safe for the rescue animal. Are you willing to have a PRL rescue do a home visit? Distance is a factor in whether or not the required home visit can be completed, but we will do our best to accommodate. The home visit gives us the chance to visit with you and make sure your home is safe for the rescue animal. Yes No

I answered all the questions and provided all references truthfully and honestly to the best of my knowlege. I will do my best to comply with BCPRL's adoption policies, which include providing a safe and loving environment for the lifetime of my new dog.