Educational Animal Adoption Application

Educational Animal Adoption Application

This form is for schools, public libraries, zoological institutions and other community-based groups.
Before you start, this is a lengthy form. We want to minimize the "back and forth" dialogue and be mindful of your time - to do so, we have developed this application that covers likely everything we need to know. You will be able to save a draft of this form if you need more time to complete it, as well as be allowed to review it before submitting it.
Before proceeding, please confirm the following:
I am over 18 years old.*

YesNo
I understand that I will be required to travel to Kenosha, Wisconsin (or another mutually agreed-upon location) for adoption, this will be by appointment only. Overnight shipping is only available in rare circumstances and is at the adopter's expense.*

YesNo
I have researched the regulations regarding exotic pet ownership prior to filling out this form. The animal that I am seeking to adopt is legal to own in my city/town, my county AND my state.*

YesNo

Your Information

We will ask to see a copy of your driver's license at the adoption appointment for identity verification.
Please enter your full legal name:*

First NameLast Name
If you go by another name on Facebook, please enter it here. (This is to help us match the inquiries we receive via our Facebook page)*
Enter N/A if not applicable
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*
Please enter a valid phone number.
Email:*
example@example.com
If you spoke to a volunteer or Board member of Badgerland Reptile Rescue regarding this animal, please list the name of the person you spoke with:*
Enter N/A if not applicable.

Your Organization
What is the name of your organization?*
What is your role at the organization?*
Provide the address of where this animal will be housed.*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If this is a classroom pet, please list the school district or college that the school belongs to:*
Type N/A if not applicable.
Do you have permission of the organization's administration to adopt this animal?*

YesNoN/A
If YES - please provide the name, email address and phone number of the administrator that has provided permission for your organization to adopt this animal.

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Who will be providing daily care of this animal?*
Please list the laws regarding reptile ownership for your town/city, county and state:*
If you are unaware on any of these three - please research before moving on to the next question :)
Does your organization hold an active commercial liability policy that covers exotic animals (meaning it directly mentions "reptiles") at educational outreach events?*

YesNoN/A
If YES, please provide the agent's name and company that covers the policy. If NO or N/A, please provide more information on that answer.*

Adoption Application
Please describe ANY AND ALL species that you are hoping to adopt for your organization - if there are any specific traits that you are seeking, such as an animal that has been handled by children or one that may have special needs, you may list those requests.*
Please describe your experience with reptiles and amphibians:*
Have you previously had, or currently have, reptiles as pets?*

Yes - I have previously had reptiles, but do not currently.Yes - I currently have reptiles.No - this would be my first pet reptile.
If you answered "yes" to the above question, please list the reptiles you had/currently have as pets, and what happened to them:*
Enter N/A if not applicable.
Has your organization ever had any other educational animals?*

Yes, we currently have educational animalsWe do not currently but have previously had educational animalsNo, we have not ever had educational animals
Please list the name, species and age of all educational animals that your organization has ever had, including current ones.*
Enter N/A if not applicable.
Describe the typical ages of individuals who this animal will be interacting with and in what setting:*
If your organization has provided you with an annual budget to care for this animal, list the amount below. If they have not provided you with a budget, you may list your estimate on how much you think it will cost to care for this animal.*
Describe the enclosure that you plan to use to house this animal - please make sure to include specific measurements.*
We will require proof of proper enclosure prior to adoption. If you have a photo of the enclosure that you will be using, you may upload that now.

Cancelof
How do you plan to make sure that children or members of the general public are not able to open the enclosure and interact with this animal without permission?*
Describe this animal's diet and where you plan to purchase these items.*
What substrate will you use for this animal?*
What heat source will you use for this animal?*
What is the make and model of the thermostat that you will be using for this animal's heat source?*
What type of UV lighting will you use for this animal?*
How often will be this animal be handled?*
What will you do with this animal during school closures? (ie: long weekends, spring break, summer break, winter break, etc.)*
Type N/A if not applicable.

Veterinary Reference

We require at least one current veterinary reference to be considered for adoption. If you do not have a veterinary reference, please provide the contact information for the veterinarian that you be using if you are selected to adopt this animal.
Veterinary Reference*

First NameLast Name
Clinic Name*
Clinic Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
How long have you been a client of this veterinarian?*
Enter N/A if not applicable.
This veterinarian:*

Will be able to provide a reference for me.Will NOT be able to provide a reference, but is the clinic that I plan to use.

Why would this animal be a good fit for your program?*
Do you have, or need, any educational materials on this animal?*
If there is anything else that we should know or you would like to tell us, in consideration of your adoption application, you may list that information here:*
Enter N/A if not applicable.
Please read and acknowledge the following statements.*

I understand that filling out this form does not guarantee that I will be selected to adopt this animal from Badgerland Reptile Rescue.I understand that multiple submissions for the same animal will be deleted.I understand that Badgerland Reptile Rescue will do its best to respond to each inquiry in a timely manner but it is a volunteer-run organization.I understand that if Badgerland Reptile Rescue does select me to adopt this animal, I will be required to travel to Kenosha, Wisconsin (or another mutually agreed-upon location) for the adoption appointment.I understand that all adoption appointments are by appointment only.I understand that Badgerland Reptile Rescue will require an adoption fee. If I choose to, I am welcome to provide an additional donation.I understand that if any of the information that I have provided is found to be incorrect or untrue, I will not be allowed to adopt this animal or any other animal from Badgerland Reptile Rescue.I understand that if I am unable to care for this animal, I must contact Badgerland Reptile Rescue. I may not sell, give away or place this animal in another home.All information provided on this form is correct, to the best of my knowledge.
By signing this digital application, I understand that my digital signature is as binding as a physical signature. *

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Educational Animal Adoption Application

Before proceeding, please confirm the following:

Your Information

Your Organization

Adoption Application

Veterinary Reference