Merlin's Refuge
Adoption Application

 

 No part of this form may be duplicated or reprinted in any media without the express written consent of Merlin's Refuge. This form generates an email message to Merlin's Refuge.

All information is confidential and proprietary to Merlin's Refuge.

Applicant Name
Email Address
Street Address
City
State
Zip
Phone
Age
Describe in detail the animals you are looking for
Would this be your first pet? Yes
No
What kind of pets have you had in the past?
Which of these pets do you still have?
(include age, sex and breed)
Have they been spayed or neutered? Yes
No
What happened to the pets you no longer have?
If you currently have pets will they (or it) adjust to a new pet in the house? Yes
No
Don't Know
Why do you want this animal?
(please check all that apply)		 Companion
Companion for other pet
Barn Cat or Mouser
Watch dog
Guard dog
Hunting
Personal Protection
Other
 
How many adults are in your family?
How many children?
Children's Ages
Does any member of your household have an allergy to animals?
How many hours each day will the animal be alone?
Explain
Which do you live in? House
Apartment
Condo
Mobile Home
Other
Do you own or rent your home? Rent
Own
If you rent, may we contact the owner to obtain permission for this animal to live in your home?
Owners Name and Phone
Will you keep the animal up-to-date on vaccinations?
Who is your veterinarian?
City or Town
If you go away for a few days, or on a vacation, who will take care of the animal?
If you move will you take the animal with you?
Have you ever applied to adopt a dog or cat in the past? Yes
No
When
Are you willing to have a representative come to see where the pet will be living?
Are you willing to take responsibility for this pet for the next ten to fifteen years?
Complete This Section if Applying to Adopt a Dog
Do you have a fenced yard?
Height of fence
What kind of fence
Is there a gate?
If not Please Explain:
If you drive a pickup truck, would you allow the dog to ride in the back?
Would you be willing to exercise the dog on a regular basis?
Method
Where will the pet be kept during the day?
During the night?

Complete This Section if Applying to Adopt a Cat
Will you keep the cat inside or out?
Will you have the cat declawed?

Applicant's Comments


This United States Postage Stamp will be issued at the new rate of 37 cents in September 2002
Please be a responsible pet owner
Spay and neuter your pets.