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Adoption Application
Step 1 of 3
33%
What type of pet are you interested in?
*
Cat
Dog
Basic Information
Name
*
First
Last
Email
*
Primary Phone
*
Alternate Phone
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Date of birth
*
Household Information
What is the type of residence you currently live in?
*
Apartment
Condo
House
Other
How long have you lived here?
*
At your current residence, you currently:
*
Own
Rent
Since you are not the property owner, AMA Animal Rescue will verify your residences current pet policy. Please tell us about your landlord below.
Landlord Name/Business
Landlord Phone
Number of adults living in your household
*
Please enter a value greater than or equal to
0
.
Number of children living in your household
*
Please enter a value greater than or equal to
0
.
Does anyone in your household have allergies?
*
Yes
No
Who will be primarily responsible for the care of this pet?
*
Is this pet a gift?
*
Yes
No
Pet Care Information
How many hours will your pet be alone each day?
*
Where will your pet be kept when you are not home?
*
Where will your pet be kept at night?
*
Do you have a fenced yard?
*
Yes
No
Do you have any other pets?
*
Yes
No
Are your other pet's vaccinations current?
*
Yes
No
Do you have a primary veterinarian?
Yes
No
What is your primary veterinarian's name?
*
Under what circumstances would you NOT keep your pet?
I like pets that are
*
Small
Medium
Large
No preference
I am looking for a pet that is:
*
Highly Energetic
Outdoorsy
A Lap Pet
Mellow
Affectionate
Quiet
Guard Dog
I prefer a pet that:
*
Loves children and strangers
Can tolerate children and strangers
Loves all other animals
Can tolerate all other animals
Don't care if he/she gets along well with other animals
Questions/Comments:
Phone
This field is for validation purposes and should be left unchanged.
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