Animal Shelter of Linn County
Adoption Application

Name:                                 Day Phone: Eve Phone

Address:                           City: State:

Zip:                                    Occupation:

Spouse's Name:          Email: Date:

Spouse's Occupation:

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        1.    Life Style:         Extremely Active           Moderately Active            Somewhat Active   

        2.   Are you Single?                  Married                  Couple, not married                  Military         

        3.   Have you ever owned a pet before?  

              Do you still have the animal or what happened to it?  

        4.    Where/whom did you get your animal from?  

        5.      If you haven't owned a pet before, have you ever spent any time with one?  

        6.    Animal applying for: cat    dog    Other  

        7.    Preference: Sex      Age      Other   

        8.    Do you have any other pets or livestock?

               If yes, please explain
               

        9.    What pets have you owned previously and what happened to them?

                

       10.    For what reason(s) would you consider giving up your pet?

                

       11.    Has your ownership of a pet ever caused you to be in a court situation? If yes, please explain:

                

       12.    Veterinary reference and phone number  

       13.    Personal reference of someone who knows you and your current or past pets well.

               

       14.    Do you have any children living in the home or are in the home on a regular basis?

               

       15.    Do you live in a house, apartment, duplex, or condo?  

       16.    Do you have a fenced yard?    What type of fencing and how high?  

       17.    Do you have a swimming pool?    Is it separately fenced?  

       18.    How often and for how long is there regularly no one at home?   

       19.    Where would the animal be during those hours?  

       20.    Where will the animal stay at night?  

       21.    Who will care for the animal on a regular basis?

       22.    Other persons in household besides those listed in question 1 who will have contact with animal?

                

       23.    Does this person approve of getting a pet?  

       24.    On vacations, what would you do with the animal?  

       25.    How will the animal get exercise?  

       26.    Some animals are untrained and not housebroken. Are you willing to take an animal like this?  

       27.    Are you familiar with crate training?  

       28.    Would you be willing to take an animal with minor health or behavioral conditions  

       29.    All dogs must be spayed or neutered as part of the adoption process. Are you willing to do this if not already been done?  

       30.    When will you be ready to take possession of the animal?  

       31.    Do you rent your residence? Yes/No  

                If so, has your landlord agreed to allow a pet in the residence?  

                Complete application, print and send or take to Shelter />