Application to Adopt a Rescued Pet

Is there an animal at the STAR Foundation you would like to adopt as a pet? Please provide us with the following information so we can assure that you are the best match for the animal you would like to adopt. All information shared with the STAR Foundation will remain completely confidential.

Today's Date
I am interested in a	Dog Cat Rabbit Guinea Pig Bird Ferret Other
ID or Name of animal
Description
Please tell us about yourself and your environment
Applicant's name
Address 1
Address 2
City
State
Zip code
Home phone
Cell phone
Email
Are you over 21?	Yes No
Do you own or rent?	Own Rent
Type of dwelling	House Apartment Condo
How long there?	years
If renting, landlord's name and phone number
If you should move, what plans would you make for your pet?
Approximate yard size
Is the yard fenced?	Yes No
Fence height
Please list all persons living with you, their ages and their relationship to you.
Person 1
Person 2
Person 3
Person 4
Person 5
If any household member does not want to adopt, please explain
Is anyone in your household allergic to pets?	Yes No
If yes, how do you plan to resolve this?
Do you and/or other members of your household work?	Yes No
If yes, how many hours each day?
How many hours will the pet be alone each day?
Please tell us about pets you presently own
Do you have any pets now?	Yes No
If yes, please provide information below for each pet you have:
Please describe Pet 1
Pet 1	M/F Neutered? Age
Where did you get Pet 1?
Please describe Pet 2
Pet 2	M/F Neutered? Age
Where did you get Pet 2?
Please describe Pet 3
Pet 3	M/F Neutered? Age
Where did you get Pet 3?
Please describe Pet 4
Pet 4	M/F Neutered? Age
Where did you get Pet 4?
Please tell us about the pet you wish to adopt
If you have had this type of pet in the past, please provide a brief history
Did you have ever have to give a pet up?	Yes No
If yes, please explain when and why.
Where will the pet stay when you are at home?
Where will the pet stay when you are out?
Where will the pet stay at night?
Who will take care of the pet while you are away - on vacation, for example?
What kind of food do you expect to feed your pet?
What is your veterinarian's name and phone number??
Are you financially prepared to provide veterinary care for this animal?	Yes No
Please provide the names and phone numbers of three people and one veterinarian (none related to you) who know or have know you and your pets.



If you are adopting a cat and currently own one or more cats, you will need to provide proof that your current cat(s) has been tested for FIV/FcLV (feline combo test) and is negative. Do you agree to this?	Yes No
We ask each adopter for an adoption donation at the time of the adoption in order to defray the cost of veterinary and foster care. Do you agree to this?	Yes No
All potential adopters must agree to a home visit. This is to ensure that our rescued pets are being adopted into safe homes. Are you willing to have someone visit your home and check references prior to the adoption?	Yes No
Would you agree to provide all necessary veterinary care, have the rescued pet spayed/neutered (if not already done), and keep proper identification on the rescued pet (if possible) at all times?	Yes No
Are you willing to sign an adoption contract?	Yes No
If, for any reason, the new pet doesn't work out in your home, do you agree to return the pet to the rescue volunteer without refund of any adoption donations paid?	Yes No
Do you, the undersigned, understand that any misrepresentation of yourself or any untruths in the information you have provided herein will invalidate any adoption agreement and will give the rescue volunteer the right to reclaim the pet without refund of any adoption donations paid?	Yes No
Clicking on the submit button below is the legal equivalent of your signature. By clicking on the submit button you agree that all the above information you have submitted is true.