First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Work Phone*
x

Cell Phone*

Alt Email

If you are UNDER the age of 21, what is your age?

Name of pet you're interested in
Choose an animal: Blossom Buddy Buddy Cheeto Coco Cypress Daisy (CL 2023) Duke (CL 2023) Fiona George Green Bean Huckleberry Finn June Bug (CL 2023) Leo Reagan 1 Panda Peppa J Pumpkin Rex (2023) Rocky Reagan 2 Samson (CL 2023) Stevie (CL 2023) Striper Yozuri (2024) Zuko

Are there any other dog(s) you're interested in?

Why are you interested in adopting this pet?*

Have you or your family ever adopted or fostered a pet?*

Have you ever applied for or adopted a pet from Save a Stray? If yes, pet's name and when?*

Name of Person or Business that referred you to Save a Stray

Occupation and Employer of the primary financial member of the household? Who is responsible for paying? *

Years with this employer*

How long have you lived in your current home?*

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home*
Choose one: Rent Own

If you rent, have you received the approval of your landlord to have an animal*
Choose one: Yes No N/A

Have you discussed pet deposits and policies (size, breed, etc) with your landlord?*

If you have a landlord, may we contact them? If yes, please provide name and phone number

Is your yard fenced*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

What type of fence
Choose one: Privacy Chain Link Invisible

What is the height of the fence

What type of street do you live on (main road, side street, private road, cul-de-sac, etc)? *

Are you okay with a home visit from a member of our team?*

For whom are you adopting this pet*
Choose one: Self Someone Else/Gift

How many adults (over 18) are in the home?*

Ages of all household members UNDER the age of 18*

Has adopting a pet been discussed with all members of the household?*

Who will be the primary care giver?*

What is the primary caregiver's typical work schedule*

Describe your home environment (busy/lots of activity, quiet/calm, etc)*

What traits are you looking for in a pet

Please tell us what role this dog will play within your family/home*

What do you expect to be the hardest part of adopting a dog and adding a pet to your home and life?*

On average, how many hours will your pet be left alone?*

Will this pet be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

What is your daily exercise plan for this dog?*

Where will this pet sleep*

Where will this pet be kept when you are not home (work, school, errands, etc)*

When you travel, how will your pet be cared for

List pets you currently own (name, breed, and age)*

Are your current pets pet friendly

Are your current pets altered (spayed/neutered)? If no, what is the reason they are not altered*

Are your current pets up to date on vaccinations?*
Choose one: Yes No N/A

Other than current pets, have you had any other pets in the last 10 years? If so, please share where they are now. If they are deceased, what was the cause of their passing?*

Which brand of heartworm and flea prevention do you currently use or have used in the past?*

Current or Prior Veterinarian's Name and Phone Number (to be used as a reference, PLEASE contact them to allow information to be given to us)*

Name of the person the vet records are listed under?*

List TWO personal references - Family Members NOT living with you or Friends that you've known 2+ years (Name, Phone, and Email)*

Save a Stray is located in Mobile, Alabama. ALL out of state meet and greets will be conducted via FaceTime. (Please initial)*

I certify that the information entered on this application is true. If I am approved to adopt a dog: 1) I promise to provide the dog described above (Dog) with a good, safe home, quality food, clean water, all necessary medical care, attention, and love for said Dog. 2) I understand that the Dog is on heartworm and flea/tick prevention. I agree to continue heartworm, flea/tick prevention in accordance with the direction of the veterinarian. I agree to have the Dog visit the veterinarian for all necessary medical care not less than once a year. 3) If at any time I am unable to care for Dog for any reason I will return Dog to Save a Stray. I understand that I can not sell or give the Dog to another person, shelter, dealer, or business. If you agree to the above and are prepared to make Dog a part of your family please sign and date. If you are not prepared to do so, do not submit app and allow the Dog to find a family that is. Enter your name and date*