WFAHS Adoption Application

Who are you interested in adopting? *

*

Dog Cat

Your name *

First & Last Name

Your Address *

Street Address

Street Address Line 2

City State

Zip Code Country

Your Email *

Phone numbers where we may contact you *

Area Code Phone Number

Names and ages of residents of your home (adults/children/grandchildren) that will be with the animal *

Please list any pets currently living in your home. Please include the following: ages, breeds, spayed/neutered *

Are your pets up to date on vaccinations? *

Yes No

Are your pets on heartworm prevention? *

Yes No

Name of your Veterinarian *

Veterinarian's Phone Number *

Where will the animal be living? *

Inside Outside Both

Approximately how many hours a day will the pet be left home alone? *

Why are you interested in adopting this pet? *

You live in a: *

Single Family Home Duplex/Twin Condo/Townhome Trailer Apartment

Do you rent or own this property? *

Rent Own

Do you have a yard? *

Yard, fenced Yard, no fence No yard (apartment/condo/townhome)

Does your municipality or place you live have certain pet/breed restrictions? *

Yes No

If yes, please explain

Are you applying to adopt a "Barn Cat"?

Yes No

Many renters and apartment complexes have breed and pet restrictions. Please check with your landlord to confirm that pets are allowed before adopting.

When will you be ready to adopt this animal? *

Today This weekend Within a week Within a month

Have you adopted from us before? If so, which pet? *

Have you adopted from other area shelters before? If yes, where? *

How did you hear about us?

I live local Facebook Newspaper Friend/Family Road Sign

If Friend/Family, list the name of the person who referred you:

Do you have any additional comments, questions or concerns? *

Applicant's Signature *

Signature date *

Thank you for taking the time to submit this form. Someone will be in contact with you soon!