First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone*

Are you a US Resident? If No, explain:

County:

Employment Information

Name of Employer (if applicable):

Please list members of your household, relationship and ages (include self): *

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 a pet?
Choose one: Yes No

Have you or will you pay any and all applicable pet deposits?
Choose one: Yes No

If you rent, please enter your landlord's name and phone number:

Name of Current Pet #1

Current Pet Age:

Please check all applicable boxes for Pet 1

Name of Current Pet #2

Age Of Animal:

Please check all applicable boxes for Pet 2

Please list any additional pets you have owned in the past 10 years and indicate if cat/dog, spayed/neutered and if living/deceased. If deceased please list cause of death.

List the name and phone number of your veterinarian(s).

May we contact your vet for a reference?
Choose one: Yes No

List the name and phone number of two individuals for pet references:*

What type of pet are you interested in adopting?
Choose all that apply: Dog Cat

Which pet are you interested in?
Choose an animal: Birdie Buster - Foster to Adopt Charles Rocky Charlotte Colin Bridgerton Daphne Bridgerton Dipsy Eloise Bridgerton Elvis Francesco Bridgerton Gabby Goose Gregory Bridgerton Hyacinth Bridgerton Lucky Lulu Maddie Moose Ollie Mon Penny Lee Po Stella

If your first choice is not available, who is your second choice?
Choose an animal: Birdie Buster - Foster to Adopt Charles Rocky Charlotte Colin Bridgerton Daphne Bridgerton Dipsy Eloise Bridgerton Elvis Francesco Bridgerton Gabby Goose Gregory Bridgerton Hyacinth Bridgerton Lucky Lulu Maddie Moose Ollie Mon Penny Lee Po Stella

Other animals you are considering:

How long have you been thinking about getting a pet?

Who in the household will care for the pet?*

What traits are you looking for in a pet?

Where will the pet spend the majority of the time?*
Choose one: Inside Only Outside Only Mostly Inside with some outside time Inside and outside equally

Will the pet be the only pet in your home? Explain:

Where will the pet be kept when you are home?*

Where will the pet be kept when you are not home?*

How much time will the pet spend alone during the day?*

Where will the pet sleep?*

Describe how you will train the pet:*

Check any of the following reasons you would give your pet away:

Have you ever given up a pet? If yes, please explain*

Have you ever adopted a pet from a rescue group or humane society? *
Choose one: Yes No

If yes, when and which group did you adopt from?

How did you hear about us?*

A well cared for pet may live over 12 years. Does your lifestyle, career and family plans allow you to make this commitment?
Choose one: Yes No

Owning a pet is a serious financial responsibility. Are you prepared financially to spend a MINIMUM of $500 per year for veterinary care (vaccinations, flea/tick and heartworm preventative) IN ADDITION to the cost of food, toys, training and treats?
Choose one: Yes No

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?

For cats only: Are you planning to declaw?
Choose one: Yes No

Would you have any objections if a RUFF volunteer made a follow-up call or visit after the adoption?

RUFF requires all pets adopted to be spayed or neutered. If you adopt an unaltered puppy, you agree to have him or her spayed & neutered.