C.A.R.E. -- Adoption Application

To be considered for adoption of a C.A.R.E. animal you must fill out this application.
Required fields are indicated by:

About you:

Name of animal you are interested in adopting:

Names of adults in household:

APPLICANT:

Full Name:

CO-APPLICANT:

Full Name:

Address Line 1:
Address Line 2:
City:
State/Province:
ZIP/Postal Code:
Country:	USA Canada Other
E-mail Address:
Home Phone:
Work Phone:	For whom?
Fax:
Best time to call:	AM PM Where? Home Work

Number of persons in household:

Adults:	Women:		Men:
Children:	Girls:		Ages:		Boys:		Ages:

Are there any regular visitors to your home, human or animal, with which your new animal must get along? Yes No: If yes, please describe type of visitor, age and frequency of visits:

How did you learn about:

C.A.R.E.?
Our web site?

About your home:

What type of dwelling do you have?

If Other, what type?

How long have you lived there?

If less than 6 months give previous address:

Address Line 1:
Address Line 2:
City:
State/Province:
Zip/Postal Code:
Country	USA Canada Other

Do you own or rent your home?

If you rent, do you have your landlord's permission to keep this animal? Yes No
Please provide your landlord's name and phone number:

Name:
Phone:

Do you have a yard? Yes No

If you have a yard is it fenced? Yes No
If yes, how high and what type is it?

Do you have a dog kennel run? Yes No

If yes, please give approximate dimensions?

Where will the animal sleep?

Where will the animal stay when you are gone?

Do you plan to use a dog crate? Yes No

Please explain why or why not:

Are there currently animals in your home? Yes No

If yes, please list them:

Type (dog, cat, bird, etc.)	Breed, if known	Age	Gender (M/F)	Neutered or Spayed (Y/N)
			M F	Y N
			M F	Y N
			M F	Y N
			M F	Y N
			M F	Y N
			M F	Y N
			M F	Y N
			M F	Y N

Pet ownership questions:

How many animals have you owned in the past five years? If you no longer have the animal(s), what happened to it (them)? (Please be specific.)

What makes you a good pet owner? (Include how you would handle any behavioral problems; e.g., chewing, scratching, biting, barking, etc.)

Why do you want this animal versus another breed or type of pet?

How will this animal fit in with your hobbies, activities, and lifestyle? (e.g., will your pet be left alone for extended periods of time (i.e., more than six to eight hours a day); how will your pet be cared for while you are on vacation?; etc)

Are there any specific behaviors or characteristics that you will expect or demand from this animal for the adoption for be successful? (e.g., good watchdog, low maintenance coat, etc)

Is there anything else you would like to tell us about your family and its suitability to adopt this animal?

Rescue animal preferences:

Please indicate any preferences you have for adopting a rescued animal from C.A.R.E.:

If the animal you are interested in is no longer available, but you are interested in leaving this application on file please answer the following:

I would prefer a:    male    female    either gender rescue animal.

Would you be willing to adopt an animal with health problems? Yes    No
If yes, to what extent would you be willing to help a sick animal?

Would you be willing to adopt a mixed breed? Yes    No

An animal that requires professional grooming? Yes    No

Are there any other traits that you prefer?

References:

If you currently own or have in the last five years owned a pet, please include your veterinarian as one of the references. Please provide the names and contact information for at least three references who can speak to your fitness as a pet owner. PLEASE DO NOT LIST MORE THAN ONE FAMILY MEMBER OR OTHER RELATION AS A REFERENCE.

Reference 1 (veterinarian if you have one):

Relationship to you:
Name:
Address Line 1:
Address Line 2:
City:
State/Province:
Zip/Postal Code:
Country	USA Canada Other
Home Phone:
Work Phone:
Best time to call:

Reference 2:

Relationship to you:
Name:
Address Line 1:
Address Line 2:
City:
State/Province:
Zip/Postal Code:
Country	USA Canada Other
Home Phone:
Work Phone:
Best time to call:

Reference 3:

Relationship to you:
Name:
Address Line 1:
Address Line 2:
City:
State/Province:
Zip/Postal Code:
Country	USA Canada Other
Home Phone:
Work Phone:
Best time to call:

Other comments:

Indemnification Agreement
I (We), the above named Applicant(s), hereby agree to release, indemnify, and covenant to hold harmless, Compassioned Animal Rescue and Education, their volunteers, and representatives, from any claims, injuries, costs, or actions incurred as a result of adopting any animal from Compassioned Animal Rescue and Education.

Thank you for your interest in adopting a rescued animal. If you have any questions please don't hesitate to contact C.A.R.E. at info@compassionedrescue.org, or:
P.O. Box 943
Milton, WA 98354-0934

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