WinWin: Adoption Application

Adoption Application

30-minutes to complete
We appreciate your interest in adopting an animal from Win Win Animal Rescue. Please complete and submit the following application so we can do our part to make it possible for you to give your new furry friend their forever home.

Questions, email winwinrescue@gmail.com and we will respond asap.
- Today's Date?
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Are you 21 years of age or older?
- How did you hear about Win Win Animal Rescue?
  
  Other
- Have you adopted a pet from Win Win Animal Rescue before?
  
  Other
- Do you agree to a home check before placement of the pet?
  
  Other
- Provide the name of the pet(s) you wish to adopt
- Who is the named pet(s) for?
- Adopting the named pet(s) above will fill which roles: (check as many that apply)
  
  Other
- What is the household members' general feelings about adopting the named pet(s)?
- Your Name
  
  First NameLast Name
- Partner's Name
  
  First NameLast Name
- Your Cell Number
  
  Area CodePhone Number
- Partner's Cell Number
  
  Area CodePhone Number
- Your Email
  example@example.com
- Partner's Email
  example@example.com
- Residential Address
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- The style of the residence is best described as:
  
  Other
- You residence is best described as:
  
  Other
- If you live in a rental, include the landlord's information.
- How long have you lived at your...?
- Please provide the following information about the household members.
- If children are routinely in the residence, how long could they be left alone with the pet(s) at a time?
- If children are routinely in the residence, how will you teach them to handle a pet(s) properly?
- Please provide the following information about the pets you "no longer" have if applicable.
- Follow-up to the previous question, briefly share about the pet(s) you "no longer" have.
- Please provide the following "general" information about the pets you "currently" have living with you.
- Please provide the following "medical" information about the pets you "currently" have living with you.
- Follow-up to the previous two questions, briefly tell us about the pet(s) you "currently" have.
- Please provide the following information for your veterinarian. (Leave blank if not applicable)
- How long has the above veterinarian cared for your pets?
- What do you consider routine veterinary care?
- The average annual cost for veterinary care for a pet is between $90 to $500 and emergency care can cost between $200 to $2000. This includes vaccines, annual check ups, and possible health or emergency care. Are you financially able and willing to assume this responsibility?
- Have you ever moved with a pet?
- Who will care for the pet daily?
- Where will the pet stay during the day?
- Where will the pet stay during the night?
- What are some of the reasons you would return the pet? Check all that apply.
  
  Other
- If you have returned a pet, please explain the circumstances?
- If something happened to you or you had a life changing event, is there someone who could assume responsibly for the pet temporarily or permanently? If yes, explain the relationship.
- Are you aware a pet can live as long as 25 years?
- What is your view on declawing cats and under what circumstance would you declaw a cat?
- Your employment status is... ?
- Please provide the following employment information, if applicable.
- Please provide two references and an emergency contact.
- Is there any additional information that might help us review your application?
- To certify the terms and conditions of this agreement; read the disclaimer, agree to the terms & conditions, add your signature, and then submit this form.
  
  Disclaimer:
  By submitting this form you are declaring the information on this form is true, accurate, and correct, and you have not omitted any pertinent information. If any statements are deemed as untrue by Win Win Animal Rescue, we have the right to close the adoption.
  
  Additionally, you are aware that Win Win Animal Rescue is not responsible for any action of an animal while in your care, custody, or control. You will take full responsibility if you are injured while an animal is in your care, custody, or control. If personal property is damaged while an animal is in your care, custody, or control Win Win Animal Rescue is not liable for replacing damaged items.
  
  Win Win Animal Rescue does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations.
  
  Win Win Animal Rescue has the right to contact any individuals listed on this form.
- Your Signature
  
  You mouse or finger to sign.
- An email response will be sent to you shortly which might be delivered to your junk or spam folder. If you do not receive an email, please contact winwinrescue@gmail.com. Thank you!
- Should be Empty: