Please read the enclosed materials carefully and answer all questions completely. Critters Companion’s adoption policy may be new to you and you should familiarize yourself with our requirements. You will be signing a legally binding contract that will require you to spay or neuter your pet by a specified date; obey all animal-related laws; provide for new licensing for any dog or cat adopted; and provide proper health care for your pet. I will not bore you with the number of dogs and cats put to death everyday of the year, but I will say if you are not part of the solution you are definitely part of the problem. WE ARE HERE TO HELP!
Volunteer Adoption Specialists are available to help you in finding the
right pet for your family, life-style, and living space, and help to prevent or
try and solve specific behavior problems that are common with all animals.
Please call 1-(920)-964-1883 and leave
a message or e-mail us at critterscompanion@gmail.com. You may e-mail this form as an attachment or
cut and paste into an email. If you
need to fill out, you may print it and mail it to PO Box 356, Wrightstown,
WI 54180.
Name: ________________________________________________________________________________
Permanent Address: _____________________________________________________________________
City, State, and Zip:____________________________________________________________________
Daytime Phone: ( )________________________ Evening: ( )_______________________________
Email: ________________________________________________________________________________
1. Have you ever had a pet before? Yes _______No _____ Type of pet: ______________________________
Do you still have this pet? Yes () or No () Spayed or Neutered (Circle one)
What type of Pet ID have you used in the past? ____________________________
Please list all the pets that are currently living at your home now:
______________________________________________________________________________________
______________________________________________________________________________________
2. What type of activities do you like to do with your pet(s)?
______________________________________________________________________________________
3. How much time each day will you or someone from your family spend with your pet?
______________________________________________________________________________________
4. Where will your pet sleep? In the house____kennel or crate____fenced yard____tie-out/chain____ garage____patio____dog run____basements____other, please explain _______________________
5. What type of confinement will your pet have? _____________________________________________
If kennel, what size? __________ Height? __________ Length? __________
Describe the yard (entirely or partially fenced, unfenced, shaded, etc.)___________________________
6. How much are you willing to spend on vet bills when necessary?_____________________________
7. Why did you choose Critters Companion to look for a pet? _____________________________
______________________________________________________________________________________
8. Does any member of your family have a pet allergy? Yes/ No/Don't Know
9. Why do you want this particular pet? Circle One. For your children-Companion for yourself-Watchdog- Mouser-Companion for other pet Other explain _________________________
10. What would you do if you were unable to care for this pet? ___________________________________
______________________________________________________________________________________
11. Are your current pets Spayed/Neutered ____Yes____No____Do not know**Are your current pets vaccinated ____Yes____No____Do Not Know
12. What type of housing do you reside in? Own home _____ Rent home _____ Apartment _____
· Condo _____ Trailer park _____ Live w/parents _____ Other _____
· How long have you lived there? __________
· Does your lease allow pets? Yes _____ No _____ Don’t Know _____
· Management/Landlord’s Name _____________________________________________
· Address __________________________ City _________________ State ______ Zip ______
· Phone number: __(____)_______________________
13. Do you work or attend school full time? Yes _____ No _____
14. Place of employment or school: ________________________________________________________
· Address: ___________________________________________________________________
· Phone number: _________________________
· How long have you been there? ________________
15. What arrangements will you make for pet while you are at work, school, or out of town?
_____________________________________________________________________________________
16. Have you ever adopted a pet from us or any other groups including out of state organizations?
_____________________________________________________________________________________
17. Have you ever tirned a pet into a shelter? If you have, please explain the situation __________________
___________________________________________________________________________________
18. Do you plan to have your new cat de-clawed? Yes/No
19. Do you have a veterinarian and if so, what is the name and phone #
_____________________________________________________________________________________
20. Name of nearest relative? ____________________________________________________________
· Address: _______________________________City: __________________
· State: _____________Zip: ____________ Phone: __________________
21. Name of personal reference not living with you: __________________________________________
· Address: _______________________________ City: ____________________
· State: _______________Zip: ___________ Phone: ___________________
I/We the undersigned; certify that all statements and answers are true and correct. I realize that any untrue statements will deem reason for refusal of adoption or reclaiming of any adopted pet(s) from Critters Companion.
___________________________________________ _______________ ____________________
Adopters Signature & Date
___________________________________________________________ ____________________
Co-Adopter Signature (If Applicable) & Date
____________________________________________________________ ____________________
Critters Companion Representative, Signature & Date