General Adoption Application

Species of pet you would like? *

What age group are you interested in? (select all that apply)

What is your preferred sex of animal? *

Preferred size when fully grown? *

Desired breed? *

First Name *

Last Name *

Date of Birth *

Street Address *

City *

State *

How long have you lived at this address? *

Email Address *

Cell Phone *

Home Phone

Occupation *

Name of employer *

Are you a veteran? *

Why do you want to adopt this pet? *

Do you have other pets? *

Please list their Species, Age, Sex and if they are Spayed/Neutered.

Who will be responsible for this animal? Please choose all that apply. *

Are you a frequent traveler? *

Where will this animal stay while you're away?

Please list all occupants in your home. (Name, Age, and Relation to You) *

Do you rent your home? *

Please provide you landlord's Name and Phone Number.

I agree, in accordance with the DCSPCA adoption contract, that if I cannot keep this animal for any reason, I will return the animal to the DCSPCA (I will not rehome or give away the animal without contacting the DCSPCA first). *

How many hours per day will this dog be left alone? *

Where will this dog be when left alone? *

How do you plan to train this dog? *

Do you acknowledge that it can take up to 2 months for a dog to adjust to a new home? *

Have you ever had a declawed cat? *

How many hours per day will this cat be left alone? *

When left alone, where will this cat be kept? *

This cat will be: *

What is your plan to introduce this animal to other animals in your home? *

Do you acknowledge that it can take up to 3 months for a cat to adjust to a new home? *

Where will this rabbit be housed? *

How many hours per day will this rabbit be left alone? *

When left alone, where will this rabbit be kept? *

If caged, how often do you plan to take this rabbit out for playtime and exercise? *

Do you acknowledge that it can take up to 3 months for an animal to adjust to a new home? *

Where will this chinchilla be housed *

How many hours per day will this chinchilla be left alone? *

Where will this ferret be housed? *

How many hours per day will this ferret be left alone? *

Where will this gerbil be housed? *

How many hours per day will this gerbil be left alone? *

Where will this guinea pig be housed? *

How many hours per day will this guinea pig be left alone? *

Where will this hamster be housed? *

How many hours per day will this hamster be left alone? *

Where will this mouse be housed? *

How many hours per day will this mouse be left alone? *

Where will this rat be housed? *

How many hours per day will this rat be left alone? *

Please provide a personal reference. (Name, Phone #, Relationship) *

Please provide the Name and Phone # of your current Veterinarian. *

*

I give the veterinarian named permission to release any and all medical information about my animals, past and present, to the DCSPCA.

For the purpose of adopting, I certify that the above statements are true and complete. The DCSPCA retains the right to deny any adoption due to false information, or if the staff believes that it is in the best interest of the animal. *