Applicant Name:
Person #1
First Name: _{( Required )}

Last Name: _{( Required )}

Age: _{( Required )}

Person #2
First Name: _{( Required, if applicable. )}

Last Name: _{( Required, if applicable. )}

Age: _{( Required, if applicable. )}

Street Address: _{( Required. )}

City: _{( Required. )}

State: _{( Required. )}

Zip: _{( Required. )}

Phone# _{555-555-1234 ( Required )}

Secondary Phone# _555-555-1234

Email Address: _{( Required )}

Employment Info

Person #1
Occupation/Employer Name: _{( Required )}

Work Hours: _{( Required )}
-

Person #2
Occupation/Employer Name: _{( Required, if applicable. )}

Work Hours: _{( Required, if applicable. )}
-

Is there a specific animal you are interested in adopting from us? —Please choose an option—DuckPigChickenGoatDonkey
If yes, please indicate the animal's name. If no, please tell us if there is anything specific you are looking for (e.g. age, size, male/female, etc.)

Home Environment

We want to make sure that the animal you're interested in is a good fit for your home environment.

Do you understand the state and local ordinances in your city & county regarding barnyard animals/livestock? —Please choose an option—YesNoUnknown_{( Required )}

May we visit your home? —Please choose an option—YesNo_{( Required )}

The property where this animal will live is? _{( Required )}
—Please choose an option—Owned by me, and I live thereOwned by me, but not where I liveA boarding facilityA property I rent/lease, and liveA property I rent/lease, and I don't live atA friends propertyA family members propertyN/AOther - Please explain
If selected Other, Please explain!

How many acres of pasture will this animal have access to?
—Please choose an option—Less than OneOne to fourFive to TenTen to FifteenFifteen to TwentyTwenty-one to FiftyFifty plus_{( Required )}

What other types of animals will share this pasture?
—Please choose an option—Less than OneHorses or donkeysGoats and or SheepPigsChickensDogsLlamas or AlpaacasOther - please explain_{( Required )}
If selected Other, Please explain!

How many total animals will share this pasture _{( Required )}

Type of fencing? _{( Required )}

This animal will be kept _{( Required )}
—Please choose an option—In a pasture 24/7In a pasture except for when eatingOn a routine pasture/stall rotation with a minimum of 4 hours in stall dailyIn stall, or other enclosure, with limited turn out timeN/A

My home, farm or boarding facility has the following amenities _{( Required )}—Please choose an option—BoardRun in shelter/loafing shedBarn with stallsBarn without stallsa thick stand of trees that he or she can seek shelter inIndoor or covered areaOutdoor arenaTrails

If you Rent:

Landlord’s Name:
Landlord's Telephone Number: _555-555-1234

Does your Landlord allow barnyard animals? —Please choose an option—Not ApplicableYesNoUnknown

Have you applied to any other rescue groups? If so, please list the group name and date of application : —Please choose an option—YesNo_{( Required )}

Vet Reference

Please list all vets you have used in the last three years for vaccines, spay/neuter etc.

Current Vet Name:

Street Address:

City:

State:

Zip:

Telephone Number: _555-555-1234

Other Vets: _{( Please include Name, Address & Phone # )}

If you currently own animals, are they all current on vaccinations? _{( Required )}—Please choose an option—YesNoHave consciously decided not to vaccinate for health reasonsI currently do not own animals

Are all of your male pets neutered/castrated or females pets spayed if it is species appropriate? —Please choose an option—YesNoI currently do not own animals_{( Required )}

Your Current Animals

What animals have you had in the past?
_{( *Please list only animals you had personal responsibility for day to day care as an adult. If none, just write None. )}

Which of these do you still have?
_{( *Include species, age, gender, and if pet lives indoors or outdoors. If none, write None )}

Do you understand that adoption from Snooty Giggles is a "Lifetime commitment"? This means that you must notify Snooty Giggles if you are ever unable to care for an animal you adopt. If you are approved to adopt, you will be required to sign an adoption contract complying with this notice provision.
—Please choose an option—YesNo_{( Required )}

Please type your full name and today's date below to acknowledge and agree to the following consent: Snooty Giggles Dog Rescue may contact my veterinarian to complete a reference check. My veterinarian is authorized to release any information requested about the care and treatment of my animals including vet records if needed.
First Name: _{( Required )}

Last Name: _{( Required )}

Date: _{( Required )}

( Required )
In submitting this application, I/we hereby certify that all the information provided on this application is true, complete and accurate to the best of my/our knowledge. I/we attest that I/we have read the Terms and Conditions of Adoption and also understand that completion and submission of this application does not guarantee adoption of a dog and Snooty Giggles Dog Rescue reserves the right to refuse any adoption.