First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Work Phone
x

Cell Phone*

Alt Email

Applicant Age*

Please list the ages of all persons living at this residence.*

What type of home do you live in?*

Do you own this home?*

If not, please list the name and phone number for your current landlord

Do you have a fenced in yard?*

Tell us about you and your family, and why you are interested in adopting?*

When would you be available to pick up this cat? *

Occupation*

The yearly cost of owning a dog can run up to hundreds if not thousands of dollars. Puppies require age specific food, toys and bedding. As part of adopting a dog/puppy from DPR, you commit to proper veterinarian care, including spay/neuter within five months of age if not already done and early checkups. Puppies are adopted out having their first of three sets of shots. Can you commit to all of this? What is your limit on vet expenses?*

Where will your pet sleep? What are your feelings on letting pets on furniture?*

How many hours will the puppy or dog be left alone in any given day? If you plan on having someone come in during the day please provide their name and phone number. *

Is anyone in your household allergic to cats or dogs? *

Who in the family will be responsible for training your new pet?*

Please list any pets you have had within the last 5 years: Type, age, and whether or not they were spayed/neutered. If they are no longer with you, please state reason why.*

Your current and/or past Vet's name and phone number. *

Personal Reference (name, email address or phone number, and relationship to you)*

If something were to happen to you and you were no longer able to care for your pets, what would you do with them?*

If you have a dog, describe how your dog interacts with other animals.*

Which of our available pets are you most interested in?
Choose an animal: Air Fryer Catfish Cinnabon Goldfish Mahi-Mahi Pike Quiznos Starbucks Subway Tetra

Would you be interested in another pet if the one you applied for is already spoken for? If so, please briefly describe the kind of pet you are looking for. *

If so, please briefly describe the type, size and sex you would be interested in hearing about*

How and where will you exercise your new pet? Have you had pets in the past that did not need a leash when being walked in open areas?*

Have you ever surrendered any animals to a shelter or had to rehome a pet? If so, why?*

I hereby give permission to Delaware Pet Rescue to contact my veterinarian to obtain information about past and present pets. I also authorize the rescue to verify the above information. I do understand that DPR makes no representation, warranty, or guarantee as to the size, health or disposition of any dog because DPR is uncertain of its background. I also understand that if I adopt a pet from DPR, the animal will have to be spayed or neutered if not already. Please type your full name to reflect electronic signature.*

Anything else you would like to tell us, or any other comments you may have?