Enter employer phone #:

Why do you want a pet ?

Do you own or rent your home?:

OWN:
RENT:

How many children live in your household: ?

Enter the ages of the children in your household ?

Enter the name of your spouse:

Enter your spouses work phone in the space provided below.

Please list two references (not relatives) and their phone numbers:

Please list the pets currently in your household, including if they are spayed/neutered and your current veterinarian:

If the pet you wish to adopt is not spayed or neutered, do you agree to spay or neuter the pet by the age of 6 months:?

YES NO

Have you previously adopted from the Kent Animal Shelter:?

YES NO

Have you visited our web site before:?

YES NO

How did you hear about the Kent Animal Shelter:?

Have you answered these questions to the best of your knowledge?

YES NO

Date of Application:

Any plans to move? YES NO

Are you 21 years of age? YES NO

Does anyone in your family have allergies? YES NO

What living arrangements will you be providing for your dog?

Where will the dog be kept when you're gone?

Who will take care of your dog when you go on vacation?

Minimum veterinary care can cost $ 100.00 per visit, can you afford this care? YES NO

Who are you adopting the pet for, yourself or as a gift?