Have you or has anyone living in your household ever been convicted, either criminally or civilly, of animal cruelty or neglect in any jurisdiction of the United States?___________If “yes”, please explain________________________________ ___________________________________________________________________ Have you ever declawed a cat or plan to declaw your new cat? (if applicable)______ Please list the pet(s) who live in your home. Include type of animal, sex, spayed or neutered, age, kept indoors/outdoors, current on annual vaccinations: Please list the types and breeds of pets you have owned in the last ten years. Include type of animal, age, how long, and what happened to him/her. Please enter the name and phone number of your most recent vet: _________________________________________________________ If you have never had a pet, please provide us with the names and phone numbers of three personal references: SURVEY FOR DOG APPLICANTS: What characteristics are you looking for in a dog? Where will your pet sleep at night? How many hours will your dog spend outside per day? My pets need to be good with: Children Elderly people Cats Other animals other than cats. Please list ___________ My pet should be high, medium or couch potato energy (please circle which one)
Have you or has anyone living in your household ever been convicted, either criminally or civilly, of animal cruelty or neglect in any jurisdiction of the United States?___________If “yes”, please explain________________________________ ___________________________________________________________________ Have you ever declawed a cat or plan to declaw your new cat? (if applicable)______ Please list the pet(s) who live in your home. Include type of animal, sex, spayed or neutered, age, kept indoors/outdoors, current on annual vaccinations: Please list the types and breeds of pets you have owned in the last ten years. Include type of animal, age, how long, and what happened to him/her. Please enter the name and phone number of your most recent vet: _________________________________________________________ If you have never had a pet, please provide us with the names and phone numbers of three personal references: SURVEY FOR DOG APPLICANTS: What characteristics are you looking for in a dog? Where will your pet sleep at night? How many hours will your dog spend outside per day? My pets need to be good with: Children Elderly people Cats Other animals other than cats. Please list ___________ My pet should be high, medium or couch potato energy (please circle which one)
acap_adoption_application_blank.docx