Adoption Application – Other Pets

About the Applicant
(Must be 18 years of age or older)

Name (required)

Email Address (required)

Home Phone

Cell Phone

Address

City
State Zip Code

Personal Information

Why do you want a pet?

If you have children in the home, what are their ages?

What has your experience with pets been like in the past? Describe in detail:

Is anyone in the house allergic to animals?
YesNo

Does your entire household agree to the adoption?
YesNo

What You're Looking For

Pet Wanted:
Guinea PigRabbitOther

Age Desired (check all that apply):
Baby (Weaned - 6 mo.)Young (6 mo. - 2 yrs)Adult (2 yrs +)

Sex:
FemaleMaleEither

Special Requests (training, color, etc.):

If pet is not altered, will it be done within 10 working days?
YesNo

How long are you willing to give your new pet to adjust to its new home?

Are you willing to give a home to an elderly pet, one with medical issues, or one that needs immediate training?

A pet with medical issues?
YesNo
An older pet?
YesNo
Pet with training issues?
YesNo

Current Living Situation

Pet to live:
Strictly IndoorsMostly IndoorEqual Time In and OutMostly Outdoor

Describe outdoor shelter for pet:

Do you own any other pets?
YesNo

Number of Cats:

Number of Dogs:

Are all dogs/cats altered?
YesNo

If you have an unaltered pet, give your reason for doing so:

Are current pets up to date on vaccinations?
YesNo

Do all current pets in your home have identification (microchipped, licensed, tags) in case they are lost?
YesNo

Describe any other pets and livestock:

Current Vet (name and phone number):

If no current vet, who you plan to use for your new pet (name and phone number):

How long have you owned your current pets?

What has happened to pets owned in the past (be specific)?

Do you rent or own?
Rent ApartmentRent HouseOwn HomeOwn Condo

Landlord's name and phone number, if applicable:

How long do you plan to live here?

Is your home located on:
City LotCountry LotAcreage

Traffic on your street is:
LightMediumHeavy

Is your yard fully fenced?
YesNo

References

Please provide information for three references (other than your vet or landlord) who know you as a pet owner or can vouch for your overall responsibility:

Reference #1:
Name

Phone

Email

Relationship

Reference #2:
Name

Phone

Email

Relationship

Reference #3:
Name

Phone

Email

Relationship

Have you spoken to an SCC adoption counselor already? If so, please list their name:

Please list which pet(s) you are interested in and why they interest you:

By submitting this application, you agree that the addition of a family pet is an important decision. You have thought through possible changes that may occur in your life, and feel you would still be willing and able to care for this pet should they occur. You agree that if for any reason you can no longer care for this pet, you will without fail contact Second Chance Companions. SCC makes random visits to adoptive homes to check on the well-being of the pet, and reserves the right to revoke the adoption if we find specific conditions are not being met. Terms will vary from pet to pet, and will be outlined on the adoption contract.

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