Please submit all applications to the email address provided
mailto:sullivancountyspca@hvc.rr.com
Please be aware that this application is for both dogs and cats, if you are filling out this application for a cat, and a certain section of this application does not apply, leave it blank.
Select this text, then copy it, and paste it into a new email message, fill in the answers  and send.

Online Adoption Application

Name of Dog/Cat  you are interested in adopting:

Date:
 


PERSONAL INFORMATION:
Name:
Email Address:
Street:
City:
State:
Zip Code:
Occupation:
Day/work Phone: ( )
Evening/home Phone: ( )

Please list place of employment for yourself and your spouse, if applicable.
SELF:
Name/Address of Employer:
SPOUSE's name:
Name/Address of Employer:


REFERENCES:
Please provide the contact information of a veterinarian you have used before and plan to use with your new dog/cat? Vet references are checked.
Vet Name:
Vet Phone:( )
Vet records are under the name of:


HOUSEHOLD INFORMATION:
RESIDENCE:
HOME: Own or Rent
CONDO: Own or Rent
APARTMENT: Own or Rent
If you rent, you must provide your landlord's contact information so that we may verify that you are allowed a pet.

List below all people who currently live at this residence:
Name:
Relation to You:
Age:

Does anyone in your house have any known allergies to dogs/cats?

List below any cats, dogs, etc. who currently live in your household:
Name: Type/Breed: Age: Sex/Neutered: How long Owned: Kept Where:

HISTORY:
Have you owned a dog/cat before? (If Yes, please provide us with a brief history of what happened to it. If your last dog/cat died, please state dog's/cat's
name and date deceased.  Has your dog/cat ever produced puppies/kittens?)
 

Have you ever taken one of your dogs/cats to a shelter? If yes please describe circumstances.

CARE OF THE DOG/CAT:
Do you have a fenced area on your property?If yes, how high is thefence and approx how large is the fenced in area?
Please describe your home and yard (i.e., single family house, 1/4acre on well traveled street).
If you have no fence, how do you plan to have your new dog/cat relieve itself?
Do all adults work full time?
How many hours each day will your new dog/cat be alone?
How many hours each day will you spend time with your dog/cat?
Where will your new dog/cat be kept when it is alone?
Where will your new dog/cat sleep?
What sort of training do you plan on providing the dog/cat?


DONATION:
We request a  donation of 75 to 300 $. This money is to help in the rescue effort and for veterinary care.  Is this acceptable?

Please realize that dogs/cats need vet care throughout their lives, including yearly boosters, heartworm and flea/tick preventive meds, etc. If you
cannot afford a donation, can you afford the appropriate vet care? Please consider this before adopting.

Are these terms acceptable to you? If so, please indicate by signing below, (not needed if sent online)

Print name:

Date:


end of application