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Which pet would you like to adopt and why?
Your Name
Address
City
State
* PetPromise only adopts to applicants where local volunteers are available to conduct home visits.
ZIP code
Phone Number
Email address
Homeowners/renters insurance company
Age of Applicant
* You must be at least 18 years of age to adopt a pet from PetPromise.
Employment/Occupation of Applicant
Number of persons in your household
One
Two
Three or more.
Children?
Yes
No
If Yes, what are their ages?
YOUR HOME
What are your living arrangements?
Own a house or detatched condominium unit
Own a condominium unit in a multi-unit building
Rent an apartment/condominium unit in a multi-unit building
Rent a house or detatched condominium unit
Live with parents
Live in college dormitory
Does your lease or homeowner's association restrict pet ownership?
Yes
No
Don't Know
Is your yard fenced?
Yes
No
REFERENCES
Please provide the names and telephone numbers of THREE REFERENCES, including your veterinarian and, if applicable, your landlord or property manager.
Other references could include a friend, neighbor, employer, relative, etc.
After submitting this application, please contact your veterinarian to let them know that they may release your pet's medical history to a PetPromise Adoption Counselor.
Due to the high volume of applications received, those without complete reference information as outlined above WILL NOT receive a response.
Veterinarian
Veterinarian for current and/or former pets (if none, enter "n/a")
Veterinarian phone number (if no vet reference, enter "n/a")
Landlord/Property manager
Landlord, property manager, or homeowners' association name (if none, enter "n/a")
Landlord, PM, or HA phone number (if no vet reference, enter "n/a")
Personal reference #1
Personal reference name
Relationship to applicant
Personal reference phone number
Personal reference #2
Personal reference name
Relationship to applicant
Personal reference phone number
CARE & RESPONSIBILITY
Are you prepared to make a commitment to care for this pet for the next 10-15 (in the case of a dog) or 18-20 years (in the case of a cat)?
Yes
No
Don't Know
Are you prepared to commit to find a home where you can keep this pet if/when you move during the next 10-20 years?
Please read Moving with a Pet.
Yes
No
Don't Know
Are you financially prepared to deal with the cost of both routine (vaccinations, annual examinations, dental cleanings, heartworm treatment, etc.) and non-routine/emergency veterinary care of this pet?
Yes
No
Don't Know
How much do you expect to spend annually to care for your pet?
Approximately how many hours a day will your new pet be alone?
Where will the dog/cat spend the day?
Where will your new pet sleep?
Who will have primary responsibility for the care of the pet?
If you are inquiring about a cat, do you intend to have him/her declawed?
Yes
No
HISTORY OF PET OWNERSHIP
What animals currently live in your household?
(Please list type of animal, sex, age and how long you have owned them)
Are these pets housed inside or outside? (please explain)
What pets have you had in the past?
(Please list type of animal, how long owned and what happened to the pet)
How did you hear about PetPromise?
All of the information that I have provided above is true and complete to the best of my knowledge. Should a dog or cat be placed with me, it will reside in my home as a pet. I agree to provide the dog or cat with adequate food, water, shelter, affection, and medical care.
Signature of Applicant:
Date of Application:
How would you like us to contact you?
E-Mail
Call during the day
Call during the evening
Text message
Thank you for taking the time to complete this questionnaire fully.
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