Kismet Adoption Application

What pet are you inquiring about? *

pet name

Name *

First Name Last Name

Cell Number

Area Code Phone Number

Home Number

Area Code Phone Number

Work Number

Area Code Phone Number

E-mail

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Co-Applicant

First Name Last Name

Cell Number

Area Code Phone Number

Work Number

Area Code Phone Number

E-mail

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Age of self and all other persons living in the home: (please list and notate any persons who regularly visit the home)

Are all family members in agreement with getting a pet? If not please explain.

Who is the pet primarily for? (Adult, Child, Elderly)

Who will primarily care for, train and exercise the pet?

Does anyone in your household have allergies? If yes, what allergens?

Please list all pets you have owned in the past ten years beginning with your current pets (include, pets name, species, sex, if they were spayed or neutered and what happened to the pet. If deceased what was their age and cause of death: *

Do you own or rent? (If renting please provide your landlords name and phone number.

If you are a renter do you have permission from your landlord to have a pet? If so up to what size and what type of pet?

How long have you lived at your current address?

May we visit your home prior to application approval?

Please tell us why you want to adopt a pet.

Please tell us a little about your lifestyle, your family, including any special activities in which your dog or cat would be included.

Please list your current veterinarian (include address and phone). If you do not currently have a veterinarian, please list your previous vet. *

What heart worm preventative do you use?

Age Desired: Any, Specific age, Senior (8yrs.+ large breeds; 10yrs. + small breeds)

Sex: (male, female or either)

Desired activity level: High, Medium or Low

Name of animal from our website you are interested in.

Why are you interested in this particular animal? Please specify.

Will this pet be allowed in the home?

How long will the pet be alone (without humans) each day?

Where will the pet stay when you are away from the house?

Dog only: Are you familiar with the use of a dog crate to train the pet during your absence or at at night?

Is your yard fenced? If so what type of fence is it (vinyl, chain link, wood etc.) and what is the height of fence?

Approximate size of pet's yard.

Will dog be walked daily? If cat will it be pet or groomed daily?

If dog, will it be exercised in a fenced yard?

If dog, will it receive formal obedience training?

Have you ever had a dog before?

Have you ever had a cat before?

If you currently have cats, are they declawed?

Do you plan on declawing a cat you adopt?

Are you aware that dogs are active?

Are you aware that the routine costs of maintaining a dog/cat average $1000.00 a year?

Have you ever sold, given away or surrendered a pet to the shelter? If yes, please specify why.

When you move or evacuate due to a hurricane what will you do with your pets?

Do you understand the state and local ordinances concerning licensing and leashing?

Have you or any member of your immediate family/household been cited for leash law violations or cruelty to animals in the past? If yes, please specify.

Please tell us how you became aware of Kismet Pet Adoptions.

Applicant Signature *

Please Type an X followed by your first and last name. This will act as your legal and binding signature.

Date

Month Day Year Date Picker Icon

Co-Applicant Signature

Please Type an X followed by your first and last name. This will act as your legal and binding signature.

Date

Month Day Year Date Picker Icon

I authorize my vet to release my pet's medical information to Kismet Pet Adoptions *

Yes No

Adoption Application

Prospective Pet Information