Adoption Application – Velvet Acres Animal Rescue

Application Code

In order to submit an application you must first contact an adoption counselor about the animal that you are interested in. They will provide you with the code to use for your application. You cannot submit the application without this code!

General Information

Name *

First

Last

Driver's License Number *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Have you ever applied for, or adopted, an animal from VAAR? *

If yes, where is the animal now? *

How did you hear about VAAR? *

Home Environment

Home Type *

Please explain your home environment *

Home Ownership *

Please explain the ownership status of your home *

Landlord name/Management Company *

Phone Number for Landlord/Management Company *

How long have you lived at this address? *

On average, how many hours will the animal be left alone during the day? *

Where will the animal spend most of its time? *

Where will the animal be kept while you are away? *

Where will the animal be kept while you are out of town? *

Financial Information

Are you currently employed? *

If no, what is your source of income? *

Who will be financially responsible for this animal? *

What do you estimate will be the annual financial cost of care for your new pet? *

Care of the Animal

Who will be the primary caretaker of the animal? *

Are you committed to taking full responsibility for the animal's health and welfare for the rest of his/her life, which could be 16 years or more? *

I'm adopting for: *

Who are you adopting for? *

Are you willing/able to provide the animal with monthly heartworm, flea, and tick protection at your own expense? *

Are you willing/able to provide a yearly exam and vaccines at your own expense? *

In general, what types of discipline/corrections do you use with your pets? *

Family

Are there any children in your household or children who visit frequently? *

Do you or anyone in your household have animal allergies? *

Are there any other people that live in your household (besides yourself)? *

Please list all members of your household

Person 1 – Name *

Person 1 – Age *

Person 2 – Name

Person 2 – Age

Person 3 – Name

Person 3 – Age

Person 4 – Name

Person 4 – Age

Person 5 – Name

Person 5 – Age

Person 6 – Name

Person 6 – Age

If you have more than 5 other people that live in your household, please add any additional members in the Comments field at the end of the form

Pets

Have you previously owned or do you currently own any pets? *

Please list all current pets AND pets you have had in the last 5 years.

Pet 1 – Name *

Pet 1 – Species *

Pet 1 – Sex *

Pet 1 – Current Vaccines? *

Do you still own Pet 1? If not, why? *

Pet 2 – Name

Pet 2 – Species

Pet 2 – Sex

Pet 2 – Current Vaccines?

Do you still own Pet 2? If not, why?

Pet 3 – Name

Pet 3 – Species

Pet 3 – Sex

Pet 3 – Current Vaccines?

Do you still own Pet 3? If not, why?

Pet 4 – Name

Pet 4 – Species

Pet 4 – Sex

Pet 4 – Current Vaccines?

Do you still own Pet 4? If not, why?

If you have had more than 4 pets in the last 5 years, please add any additional pets in the Comments field at the end of the form

Veterinarian Information

Please list all veterinarians that you have taken your pets to in the last 5 years.

Vet 1 – Name *

Vet 1 – Phone *

Vet 1 – Year of Last Visit *

Vet 2 – Name

Vet 2 – Phone

Vet 2 – Year of Last Visit

Vet 3 – Name

Vet 3 – Phone

Vet 3 – Year of Last Visit

If you have taken your pets to more than 3 vets in the last 5 years, please add any additional vets in the Comments field at the end of the form

What species of animal are you applying to adopt? *

Cat Specific Questions

Why do you want to adopt a cat? (Select all that apply) *

Other reason *

Under what circumstances would you consider giving up a cat? *

Other reason *

If you currently have cats, are any of them declawed? *

Do you plan to declaw this cat or any of your current cats? *

What are the reasons you would consider declawing a cat? (Select all that apply) *

Other reason *

Dog Specific Questions

Why do you want to adopt a dog? *

Other reason *

Under what circumstances would you consider giving up a dog? *

Other reason *

Will you be using a crate for the purpose of training? *

Do you have a fenced-in yard? *

How high is the fence (in feet)? *

What material is the fence made of? *

When the dog is outdoors, how will he or she be contained? *

Other containment method *

Small Animal Specific Questions

Why do you want to adopt a small animal? (Select all that apply) *

Other reason *

Under what circumstances would you consider giving up a small animal? *

Other reason *

Comments

Any additional information you would like for us to consider when reviewing your application?

Terms of Application *

I Agree to the Terms of Application

By checking this box I certify that I am the applicant listed above. All information provided on this application is true and correct to the best of my knowledge. Any information determined to be false can be grounds for the denial of the adoption application at the sole discretion of VAAR staff.