First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone
Work Phone x
Cell Phone
Alt Email
Text/Pager Email
Which animal are you interested in?* Choose an animal: Brie Bubba Sparx Croquette Norah Spice Tootsie Roll Zooey
Employer*
Occupation*
Date of Birth*
Co-Applicant Name
Co-Applicant DOB
Co-Applicant Employer
Co-Applicant Occupation
Co-Applicant Email
Co-Applicant Phone
Do you live in a:* Choose one: House Apartment Townhome/Condo Duplex Other
Your Home: Do you* Choose one: Own Rent Live with Family
If rent, please provide name and address of landlord
If Rent: Do you have landlord's permission to have a pet?
If Rent: What is the pet deposit:
Are you planning on moving in the next 2 years?
How long at current address?*
Do you travel for work at all?
If yes- how much of the time are you out of town?
How many adults are in your house? *
How many children are in your house?*
Ages of children
Is there anyone in your home with pet allergies?
Do you have pets in your home currently?
Please list breed, age and sex of all pets in your household:
Are all dogs and cats currently in the home spayed and/or neutered?
If No, is there a particular reason they are not altered?
How many dogs have you owned in the past (as an adult)? *
What happened to them? Be specific (dead is not specific, please tell us how/why):
Have you ever had to find your pet another home for any reason?
If yes, Please explain:
What circumstances to you are acceptable to find your cat another home?
Why are you looking at getting a pet now?*
What personality traits would you like?
Do you plan on declawing the cat?
Will the animal be allowed on the furniture?
How would you discipline your pet if it misbehaved (got into the trashcan, ate your shoes, etc?*
What BRAND of food will you feed your pet?*
What would you consider a realistic cost to properly care for your pet for one year?*
Realizing pets can live up to 20 years, are you committed to a new pet for the duration of their life?
If something were to happen to you, what would happen to your pets? *
If your pet has any behavioral problems, in the future, what would you be willing to do? *
What if your pet comes down with a serious medical problem that's very expensive, what would you do?
If you decided to move to a place that didn't allow pets, what would you do?*
Do you expect any major life changes within the next 10 years - marriage, children, etc?
Is there anything else that you would like us to know?
What is your vet's name, address and number?*
Please provide three personal references that we may call to verify information above. Name, phone number and relationship*
Please confirm your email address*
You understand that you are in agreement and compliance to our application process and agree that everything on this application is true.* Choose one: Yes No
