Name of dog you are interested in:

Your full name:

Cell Phone Number:

Your email address:

Names, genders and ages of all residents of your home and their relationship to you:

Does anyone in your household have any known allergies to any kind of animals?
YesNo

Your address:

How long at current address:

House/Apartment/Condo?
HouseApartmentCondo

Rent/Own?
RentOwn

If you rent/lease, what is your landlord’s name and phone number?

Are pets allowed per your lease/rental agreement?
YesNo

Employer’s Name:

How long at your current job?

Please provide 2 references (not immediate family) with email, phone number, address and relationship to you:

Please list all current pets in your home. Are all pets spayed or neutered and on flea/tick, heartworm prevention and up to date on vaccines including rabies?

What characteristics are you looking for? Please include age, size, gender, etc. and why you would like to adopt a rescue dog. Please be specific so that we can find a perfect match for you:

Who will primarily care for this dog (feeding, playtime, walks, training, vet visits)?

Have you ever surrendered or given away any pet? If yes, please explain the circumstances:

Please provide the name, address, and phone number of your current veterinarian. We may contact your vet, please let them know in advance. If you do not have a current veterinarian, who do you plan to use?

Do you have a fenced in yard?
YesNo

If yes, please describe the fenced in area:

Rescue dogs may take 3 weeks or more to adjust to a new home. Where do you plan to keep this dog and how long will the dog be left alone during the day? Will you be using a crate? Will you provide basic obedience training or any training if needed by a professional trainer? Be specific:

If for ANY reason you can’t keep this dog, he or she must be surrendered back to Beacon of Light Animal Rescue, Inc. There will be no refund of the adoption fee after 30 days from date of adoption.

I certify that all information is true and accurate and I understand that any falsification may result in nullification of an adoption. Please sign and date this application and return to: megan.keefe@bolarct.org

Signature:

Date:

Name of feline(s) you are interested in:

If unavailable, what other feline(s) would you be interested in?

Name of applicant:

Street address:

City/State/Zip:

Phone #:

E-mail:

How long have you lived at this address?

If less than 3 years, please provide previous address:

Do you own this residence or rent?
OwnRent

If you rent, please provide your landlord’s name and phone number:

Are you adopting for yourself or someone else?

If for someone else, please provide their name and address:

Who resides in this household? If under the age of 18, please provide their ages:

Does anyone in the home have any known allergies to animals?
YesNo

If yes, how are they controlled?

Do you currently own any animals?
YesNo

If yes, please provide their names, ages, and what type of animal:

Have they been spayed or neutered? Are they current on vaccinations? Have they been tested for feline leukemia? Have they been tested for FIV? Are they declawed?

Will this/these feline(s) be declawed? If so, please provide the age this will this be done?

Have you or your family members owned animals in the past? If so, what happened with them?

Are all members in your household in agreement to adopting a rescued animal(s)?
YesNo

Will this/these feline(s) be indoor or indoor/outdoor?
IndoorIndoor/Outdoor

Will you allow the feline(s) time to adjust to his/her new environment before introducing them to the outdoors?

What do you plan to do with your pet when you go on vacation?

What will you do with your pet if you can no longer keep him/her/them?

Name of veterinarian:

Phone Number:

Past Veterinarian Information: Name:

Phone Number:

Are you over the age of 18?
YesNo

Submission of this application does not guarantee the adoption of an animal(s). Applications usually take 3-5 days to process. Please understand that we are all volunteers and life can get in the way, so please be patient with us. Thank you.