In order to be considered as an adopter, you must be 1) at least 18 years of age, 2) be able and willing to spend the time and money
to provide proper care, training & veterinary support. Animal guardianship is a major responsibility and a long-term commitment.
You will be sharing your life with a cat or dog for 15 or more years. In All Creatures' ongoing effort to find the best match between
prospective caretakers and the animals, we ask that you take the time to fill out this questionnaire.
Name___________________________________Spouse/Partner________________________
Address___________________________________________City____________Zip_________
Your
Age Range: 20s ____ 30s ____ 40s ____ 50s ____ 60s ____ 70s ____ Older ____
Partner's Age Range: 20s ____ 30s ____ 40s ____ 50s ____
60s ____ 70s ____ Older ____
Do you Own? House___ Apt ___Condo ____ Other ________How long?_______
Do you Rent? House ___Apt
___Condo____ Other________ How long? _______
If renting, does owner/mgt allow animals? _____ Is it written in your lease?
____
Interest in: CAT___ DOG _____. Male ____ Female ____ Either _____
SPECIFIC ANIMAL or Breed ________________How soon
do you want him/her? ________
HOME PHONE___________________ Work______________Cell__________________
FAX_____________
E-Mail___________________
Why do you want to adopt an animal?_____________________________________________
Is the animal a gift?
______ Are you familiar with this breed? ______
If you're interested in adopting a cat, will you have the cat declawed? _______
If you're
interested in adopting a cat, do you plan to keep him/her:
Indoors ____Outdoors ___ Both ____
How many animals have you had in the
last five years?_____________
What kind(s), breed, sex & ages__________________________________________________ __________________________________________________________________________
What
happened to those no longer with you? If died, causes of death: ____________________________________________________________________________________
What
animals are at home now? And what are their sex & ages?_________________________________________________________ _____________________________________________________________________________________
Have
they all been spayed/neutered?___________ If not, why not?________________
Veterinarian Reference_____________________________________________________
Personal
Reference_________________________________________________________
# of Adults in the home_____ # of Children at home ______
Sex &
ages of Children_____________ Does anyone in household have allergies? ________
Do all members of household want an animal? ________
Who
will be primarily responsible for the animal?______________
Who will be responsible if something were to happen to you?_______________
What
is your occupation? _______________________Where?________________________
Spouse/Partner's occupation?____________________Where?________________________
HOW MANY HOURS are you away from home each day? _________
HOW MANY HOURS is your spouse/partner away from home? ________
Where will
the animal stay during the day?_____________
Where will the animal sleep at night? _______________
Do you have screens on your
windows? ____a yard? ____ a patio? ____ fenced? _____
how high? _____
If you go away for a few days, who will care for the animal?
_______________________
How long do you plan to keep this animal? __________________
Under what circumstances would you surrender him/her?_________________________________________________________________
~
If dog needs obedience training, are you willing and able to do this? __________
~ If dog needs house training, are you willing and
able to do this? _________
In case your animal had an emergency or serious illness, how much would you be willing/able to spend
on
veterinary care? $100 ____ $250 ____ $500 ____ $1000 ____ Whatever it takes _____
Would you object to an All Creatures' representative
visiting your home, either before or following
an adoption? ______
Would you be willing to foster a dog while waiting for your preferred
permanent dog? _________
How did you learn about All Creatures? _____________________________
Additional information for us to consider
regarding the animal you__________ ___________________________________________________________
___________________________________________________________
Signature(s)
_________________________________________________
Date: ______________
All Creatures Animal Caring Society ~ P. O. Box 3664, San
Rafael, CA 94912
Office: 415-456-1941 ~ Fax: 415-456-2003 ~ e-mail, click on:
