Allbreed Rescue and Referral
301-775-2777
robn2001@aol.com
JillBarsky@aol.com

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Pet Request Form

Let us know what kind of pet you are looking for. If you are unable to find a pet on this site, we may be able to match you up. Complete this form and we will cross reference your request against our information. If there is a match, we'll give you a call!

What kind of pet are you looking for?

  Want a dog
  Want a cat
  Want a rabbit
  Want a bird

Want other (please describe)

Your name

Address

City

County

State

Zip

Home Phone

Work Phone

Fax

E-mail

Do you

  Own
  Rent

Choose one of these options

  Apartment
  Condo
  House
  Townhouse

Have you ever adopted a pet before?

Will you accept a close mix of breed or a mixed breed?

What colors would you accept?

Which sex?

  Male
  Female

What size, in pounds?

Age range (if you work, under age 1 is best)

CATS ONLY
Will the cat you adopt be

  Indoor cat
  Outdoor cat
  Indoor/outdoor cat

CATS ONLY
Declawing

  Plan to declaw
  Present cats declawed

DOGS ONLY
Where will the dog sleep?

Where will the dog stay during the day?

How will the dog be confined while outdoors?

Please list all other pets in your home. State breed, age, sex, and if they are spayed/neutered.

How many children live in your home?

Please list children’s ages

Do you have any comments or questions?