City of Olive Branch, Mississippi

Pet Adoption Application


Name:
Email:
Address:   City:
State:   Zip:
 

Employer

How long with current employer?

 

Please include area code with all phone numbers listed:

Home Phone 

Work Phone   

Cell Phones:       or     

What is the best time to reach you by phone and at which number?

 

 

Is this application for a currently available dog or cat?

If Yes, which one?  

Do you rent or own?       House, Townhome, Mobile Home, Apartment?  

If you rent, we will need permission to see your lease agreement

or make contact with your landlord before approval of an adoption.

Landlord Name

Landlord Phone Number 

How long have you lived at the current address?

Do you have plans to move within the next 6 months?

If you have children at home, what are their ages? 

   Do all adults at the residence work full time? 

List below any pets you currently own:

          Name                                                      Type/Breed                                Age        Is the Pet Altered?      

                                       

                                       

                                       

                                       

                                       

For dog adoptions:

Do you have a fenced area on your property? 

If yes, please describe your fence (i.e. type, height) 

If not, how do you plan to have your dog relieve him/herself? 

What type of training will you pursue for your new dog?

How many hours each day do you plan to spend with your pet? 

Where will the new pet be kept when it is alone?

Where will your new pet sleep? 

Please list contact information for a veterinarian that you have used before.   Vet references are checked. 

DO YOU APPROVE OF THIS VETERINARIAN BEING CONTACTED FOR A REFERENCE CHECK? 

Vet Name: 

Vet Phone Number (include area code):

Name under which your records will be listed: 

Is this animal being adopted for yourself or as a gift? 

If as a gift, does the person know that you are giving them this gift?

Does this person reside in your home? 

Name of person you are getting pet as gift for:     

Relation of that person to you:   

The fee to adopt an animal is $15 (non-refundable) payable at the time of adoption.    All animals must be spayed or neutered and are given vaccinations prior to adoption.  The cost of spay/neuter will be incurred by the adopter.

Are these terms acceptable? 

Please realize that dogs and cats need medical care through their lives, including yearly boosters, heartworm and flea/tick preventatives.  Adopting a pet is  LIFETIME COMMITMENT and it may take time for an animal to adjust to new surroundings.   Please consider this before adopting.

I certify that I am eighteen (18) years of age or older and that these answers are true and correct to the best of my knowledge. 

and have read the above Adoption Application and will execute same promptly upon receipt of the animal. 

All medical records and pertinent information related to the animal will be provided to you upon receipt.

Signature (type name here if completing online):

Date: 

Please return this application by pressing the Submit button, or you may print it and mail it to:

City of Olive Branch Animal Shelter

9200 Pigeon Roost
Olive Branch, MS  38654