Do you have a specific animal in mind?

Yes  No Which animal? Did you speak with a volunteer regarding this animal?  Yes  No What was the volunteer's name with whom you spoke?

Housing

Rent Apartment  Rent House  Own House  Live With Parents  Live With Owner of Home  Other (condo, trailer, etc.) Is ownership listed under your name?  Yes No Landlord / Owner Information Name Address

How many years have you been at your present address?

Less Than 6 Months 6 Months to 1 Year 2 Years 3 Years 4 Years 5 to 10 Years 11 or More Years

Are you planning on moving within the next six months?

Yes  No

If you were forced to move, what would you do with your pet?

Who will care for your pet while you are away on vacations?

What hours is someone usually home? Check all that apply.

6 AM to 8 AM	8 AM to 11 AM	11 AM to 1 PM	1 PM to 3 PM
3 PM to 6 PM	6 PM to 9 PM	9 PM to Midnight	Midnight to 6 AM

How many people live in your household?

Adults: 1 2 3 4 5 or more Children 0 1 2 3 4 5 or more Children's ages:

Does anyone in your household have allergies?

Yes  No Please specify allergies:

Who will be primarily responsible for the care of this pet?

Why do you want this type of pet?

For whom are you adopting this pet?

Where will this animal spend most of its time (inside/outside, crated, etc.)?

Will the animal be allowed outside?

Yes  No When outside, how will the animal be confined?

If adopting a cat, do you plan on declawing?

Yes  No  Unsure

Are you able and willing to commit the time, effort and money necessary to properly care for and train this animal?

Yes  No

Do you understand that animals can take a considerable period of time to adjust to a new home and new situations?

Yes  No

Are you willing to give this animal a MINIMUM of two months to adjust to your home?

Yes  No

How often do you feel an animal should go to the veterinarian?

Monthly

Every 6 Months

Every Year

Every 2 Years

Every 5 Years

Only when injured or sick

Please list the animal(s) you have owned in the last seven years

Breed	Name	Age	Sex	Altered?	Kept where?	Still with you?
			Male Female		Indoors  Outdoors	Yes No
What happened to this pet?
			Male Female		Indoors  Outdoors	Yes No
What happened to this pet?
			Male Female		Indoors  Outdoors	Yes No
What happened to this pet?
			Male Female		Indoors  Outdoors	Yes No
What happened to this pet?

Please list the name and number of your veterinarian:

What will you do if your present pet does not get along with your new pet?

Are you aware of, and able to meet, the financial responsibility of pet ownership?
(Cats - $300 to $600 per year, Dogs - $400 to $800 per year)

Yes  No

How did you find out about Animal Allies?

Are you a member of Animal Allies?

Yes  No

Would you be interested in fostering a special needs animal for Animal Allies
(special needs animals may be pregnant females, orphaned kittens/puppies, injured, requiring socialization)?

Yes  No

I certify that the information I have supplied above is true and that any false statements may result in nullifying this adoption. I further understand that this application is the property of Animal Allies and will be retained by them. I also agree to contact a representative of Animal Allies immediately for permission to return any animal I may adopt from this Shelter should I need to relinquish ownership of this animal at any time.

Signed:
My initials, entered in the box above, constitute an electronic signature which is a valid and legal substitution for my written signature.

Thank you for considering adopting a pet from Animal Allies. Please read below before submitting your application:

We sincerely hope that we may be of service to you. Please fill out this application completely. The application is designed to assist the potential adopter in finding an animal suitable to his/her lifestyle.

The animals here at the shelter are termed "random source." This means that we accept animals from all sources including stray, abandoned, and homeless animals. THERE IS SOME RISK IN ADOPTING AN ANIMAL from any shelter or humane organization since frequently we have no background information on the health and temperament of an animal or information given to us in inaccurate. We attempt to evaluate all incoming animals for health and temperament problems; however, thorough health screenings are not provided. Often certain types of problems will not demonstrate themselves until the animal is in a home situation or a specific time period has elapsed (as in the incubation period of certain viruses). For these reasons, WE DO NOT GUARANTEE THE HEALTH OR TEMPERAMENT OF ANY ANIMAL and urge the owner of a newly adopted animal to bring the animal to a veterinarian for a thorough health screening as soon as possible.

Some of the animals at Animal Allies have come from abusive or negligent homes. As a potential adopter, please be aware that most of the animals that are up for adoption will need an abundance of patience, understanding, time and training to make them agreeable companions.

In order to be considered as an adopter today, you must:

• BE 21 YEARS OF AGE OR OLDER.
• Have identification showing your present address.
• Have the knowledge and consent to adopt of all adults living in your household.
• Have the cash to pay the adoption fee or, if paying by check, have a valid NH driver's license.
• Have the knowledge and consent of your landlord or the person owning the premises in which the animal will live.
• Understand that this application is the property of Animal Allies and will be retained in its files.
• Understand that Animal Allies has full authority to approve or deny your adoption application.
• Understand that Animal Allies reserves the right to verify all information submitted on this application, including veterinary information.
• UNDERSTAND THAT YOU MAY NOT TRANSFER OWNERSHIP OF ANY ANIMAL ADOPTED FROM ANIMAL ALLIES TO ANOTHER PARTY. IF YOU MUST RELINQUISH OWNERSHIP OF ANY ANIMAL YOU HAVE ADOPTED FROM ANIMAL ALLIES, YOU MUST CONTACT A REPRESENTATIVE OF ANIMAL ALLIES FOR PERMISSION TO RETURN THE ANIMAL TO ANIMAL ALLIES.