Little Squirt Rescue
W6387 County Road JJ
Appleton, WI 54913
Phone: (920) 757-6402
Fax: (920) 202-5006
Email: littlesquirtrescue@yahoo.com
"Finding permanent loving homes since 1993"
Type of Pet Looking to Adopt:
Date:
Pet's Name Applying for:
Pet's Description:
Last Name:
First Name:
Middle Name:
Birthdate:
Spouse/Roomate/Partner:
Last Name:
First Name:
Middle Name:
Birthdate:
Address:
City:
County:
State:
Zip:
Length of Time at This Address:
If Less Than 2 Years List Previous Address Below:
Address:
City:
County:
State:
Zip:
Email Address:
Phone Number(s); Home:
Work:
Cell:
Employer's Name:
Address:
Employer's Phone:
Names and Ages of All Children Under 18 Years-
Do you Rent or Own?
If Rent, Please Include Name and Phone Number of Landlord:
Name:
Phone:
Names, Ages, and Type of all Pets in your Household:
What Veterinarian do you use?
City:
Phone #
Personal References;
Name:
Phone #
Name:
Phone #
Any Additional Information that you would like to share;
* We do not HOLD an animal based on an approved application, as we many times have more than one approved application per adoptable pet. After receiving notice of an approved application, the approved applicant must then pay the adoption fee, in order to finalize the adoption. Please note we currently only accept cash as payment.
* In order to ensure the best homes for our rescued pets, we reserve the right to deny any adoption application, at any given time.
* We do not typically send any animal home the same day as being adopted. We have to update paperwork, verify vaccinations and update them if needed. We also like to groom them before being sent to their new home.
* You agree that this animal is being adopted as a family pet. He/she will have extensive house privileges, will sleep inside the house, and will not be kept solely outside. You agree to provide this animal with proper food, water, shelter and necessary veterinary treatment, including vaccinations, Heartworm preventative, annual exams and spaying/neutering any animal under 6 months of age. Proof of spay/neuter must be mailed or faxed to rescue at (920)202-5006.
* At the date of adoption, Adopter agrees to assume all medical expenses, food, grooming and any other cost associated with this animal.
* Adopter understands that no one can predict what medical or temperament problems an animal may have in its lifetime. No one from our organization may guarantee anything other than the current health and temperament of this animal.
* Little Squirt Rescue makes no guarantees or statement regarding an animals age, breed, health or temperament. While Little Squirt Rescue has made every effort to provide accurate history and assessment of this animal, most of the animals coming to our rescue have little known about their pasts. We do our best to assess the animal accurately while at our facility. All adopted pets need time to adjust to their new homes, please give them the patience they so desperately desire and deserve.
* Little Squirt Rescue is not responsible for any injury, damage, or harm caused by this adopted animal.
* Little Squirt Rescue reserves the right to enforce this contract in order to protect the welfare of the adopted animal. If the terms and conditions of this Adoption Agreement are not upheld, Little Squirt Rescue reserves the right to terminate this agreement, and to reclaim the animal. Adopter will pay for any and all attorney costs, court fees, and or other legal fees incurred, in the process of enforcing this contract.
* If you rent, a copy of your lease and addendum for pets must be presented, matching the above information that you have provided.
* Violation of this signed document will result in the loss of ownership of animal.
* Please be advised that we do background checks on ALL submitted applications.
IF ADOPTING A CAT/KITTEN YOU MUST BRING A SECURE CAT CARRIER WITH YOU WHEN PICKING THEM UP!
IF ADOPTING A DOG/PUPPY, PLEASE BRING A COLLAR AND LEASH WITH YOU WHEN PICKING THEM UP!
Signed:
Date:
PLEASE PRINT A COPY OF THIS APPLICATION FOR YOUR RECORDS !!!