Adoption Application

Today's date:

First name:    Last name:
Current Street Address:
City:    State:    Zip Code:
Home phone number:    Work Phone number:
E-Mail:
Occupation:

Why do you want to adopt a pet?
Family Pet   Child's Pet   Companion for Self   Companion for Pet
Other (Please explain)  

What type of Animal are you interested in adopting?
(Please check all that apply)                                                                                                                                     Cat   Dog
1. Age: (3-6 Mos.)   (6 Mo-1 Yr)   (1 Yr +)   Special Needs
2. Sex: Female   Male
3. Hair: Short   Medium   Long

If you saw a pet you are interested in adopting at a TAAS Adoption Fair please list its name here:

When home alone, where will the animal stay?
Basement Garage One Room in the House Run of the House Outdoors Other

Where will the animal sleep at night?

When will the animal  be allowed outside?
When I am home   On a leash   On deck or patio   On screened patio
Out during the day; in at night   Never   When the cat wants   Other

Have you ever owned a pet before? YesNo
If yes, please provide a history of your pets past and present:

Do you currently have pets?YesNo
Who is your veterinarian?
Veterinarianphone:

Please list family members (including yourself) who will have contact with this animal:

Do you live in: Apartment Condominium Mobile Home Single Family Home Townhouse
Do you rent your housing?YesNo

You will be contacted as soon as your application is processed. Please expect to be contacted within 72 hours. You are expected to meet with a representative of TAAS before an animal is released into your care. To ensure that the animals adopted through TAAS have the best quality of life and care, TAAS reserves the right to decline any potential applicants.