pear_program

 

 


RESPONSIBLE PET OWNERS ALLIANCE
APPLICATION FOR ANIMAL ADOPTION

All animals adopted through the RPOA Animal Education, Rescue and Adoption Program must be spayed/neutered. Dogs will be certified as heartworm negative when adopted and must be kept on heartworm preventive medication after adoption.

There is an adoption fee of $_____________

Breed or Species
____________________________________________________

Do you have children? _______
If yes, specify age(s)_________________________

Do you have other pets? _______
If yes, specify type, sex etc. _________________

Current veterinarian?  __________________________________________________

Do you have a fenced yard? __________ If not, exercise program? _______________

To be kept indoors?__________Outdoors?__________Shelter?___________________

Do you live in a house, apartment, condo, or mobile home? _______________________

If leasing, is there a weight limit on dogs? __________________________________

Will you keep a collar and tag with proper ID on your pet? _____________________

Are you familiar with animal regulations in your area? ________

Do you have a preference as to MALE?________FEMALE?____________________

Color?_______  Age?______  Older dog O.K?_____
Short coat ?___  Long coat?___

===============================================================
Responsible Pet Owners Alliance makes no claim or representations as to the temperament, health, or mental disposition/personality of any animal available for adoption.  I agree to indemnify and hold harmless Responsible Pet Owners Alliance, the individual rescue agent and/or group from any claims arising from this adoption.
                                                                                           DATE:________________
NAME:________________________________________

ADDRESS:_____________________________________

CITY/STATE/ZIP:_______________________________

HOME PHONE:______________________WORK PHONE:______________________

 




 

 

 

 

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