Name
*
First Name
Last Name
Email / Phone contact
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
(###)
###
####
Own/Rent?
*
Own
Rent
Owned Home on Rented Lot
Live with Parents
(If Renting) Owner's Name
First Name
Last Name
(If Renting) Owner's Phone
(###)
###
####
How many adults live in your household?
*
How many children live in your household?
*
If there are children in the home, what are their ages?
Does anyone in your household have any pet or environmental allergies, and if so, what are they?
Do you have a fenced yard?
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Yes
No
If so please describe the height and type of fencing material.
If you don’t have a fence now, do you plan to build one in the future?
Yes
No
Have you adopted before?
*
Yes
No
Have you been refused an adoption of a pet before?
*
Yes
No
If yes, explain the circumstances
What will this pet's role be in your home?
*
Companion
Companion for Child
Companion for Another Pet
Watchdog
Breeding
Business Mascot
Hunting Dog
Working/Barn Cat
Who will be responsible for feeding?
*
Who will be responsible for training?
*
List any pets you've had in the last 5 years.
Include their type, breed, age, if they were spayed/neutered, vaccinated, if they're still part of your household, and if not, why?
List your current veterinarian (if any)
If you currently have any pets, when was their last visit to the vet, and what was the reason for the vet visit?
If you move in the future, what will you do with me and your other pets?
About how many hours a day will I be alone in the home without human companionship?
*
About how many days per week will I be alone in the home without human companionship?
*
Where will I be kept during the day?
*
Where will I be kept at night?
*
Do you plan to use a chain, rope or cable as the only means of keeping me confined?
*
Yes
No
Do you fee l that female dogs/cats should be spayed?
*
Yes
No
Do you feel that male dogs/cats should be neutered?
*
Yes
No
Do you plan to take me to obedience classes?
*
Yes
No
Have you ever been involved with an animal control department? And if so, what were the circumstances?
Please provide details on when, where this involvement took place, and as much detail as you can.
First Reference Name
*
First Name
Last Name
First Reference Phone
*
(###)
###
####
Second Reference Name
*
First Name
Last Name
Second Reference Phone
*
(###)
###
####
Did you know...
*
... in the first year, regular preventative medicine may cost $150 for an adult dog /cat and $200for a kitten/puppy?
... that in the first year, my food and pet supplies may cost $100?
I Understand and agree that...
*
... pet overpopulation is a serious problem.
... state laws may require vaccinating, licensing, and in the case of dogs, leashing.
... taking on a pet if a lifelong commitment that I am ready and willing to provide.
... it may take two weeks for a new pet to adjust to a new home, or longer if other pets are there. And I am willing to give a new pet time to adjust.
... this application does not guarantee your approval for this dog/cat. TBC will need to do a background check, home check, and a vet check. TBC reserves the right to decline approval of this application for reasons that may not be disclosed to you. By signing of this application you have provided TBC your understanding that you will NOT hold any TBC member accountable for that decision. And further will NOT pursue TBC in any formal public complaint or suit.
... if approved for adoption, TBC will allow you to hold this animal for the 90 day “Babble rule” in which you have agreed to vet this animal if needed for any healthcare issues. During this 90 day “Babble rule” probation period your adoption fee will be held. If you are approved, TBC will then cash your fee. If you are NOT approved your total fee will be returned ONLY AFTER the animal is returned to TBC. Any costs for vet bills that you have incurred, TBC will agree to reimburse with proper receipt from your vet. TBC reserves the right to visit your home during the 90 day “Babble rule” probation period, and there will be one follow up visit after the probation period. These visit(s) will NOT be announced or appointed prior to a TBC member visiting.
A few final things.
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I am at least 18 years old.
All adults in my household agree to bringing a new pet into the home.
If I have an issue after adoption, I will agree to reach out to TBC for guidance and/or assistance.
Date
*
MM
DD
YYYY