About You and Your Household

Some basic information and how we can get in touch with you.

Applicant Name: _{( Required )}

Street Address: _{( Required )}

Street Address: _{( Required )}

City: _{( Required )}

State: _{( Required )}

Zip: _{( Required )}

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

Secondary Phone# _555-555-1234

Email Address: _{( Required )}

Age: _{( Required )}

Choose the small animal you're interested in from the following:
—Please choose an option—RabbitGuinea PigReptileChinchillaOther

Employment Info

Occupation/Employer Name: _{( Required )}

Home Environment

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

Have you applied to any other rescue group? If so, please list the group name: _{( Required )}—Please choose an option—YesNo

Is there a pet limit in your city or county? If so, what is the limit? —Please choose an option—YesNoUnknown
May we visit your home? —Please choose an option—YesNo

Please list the names and ages of all persons who live in your household (or who visit regularly):

Name:
Age:   
Pet Allergies? —Please choose an option—YesNo

Name:
Age:   
Pet Allergies? —Please choose an option—YesNo

Name:
Age:   
Pet Allergies? —Please choose an option—YesNo

Name:
Age:   
Pet Allergies? YesNo

What pets do your currently have in your household?

Type: —Please choose an option—SpayedNeutered
Age:  —Please choose an option—IndoorOutdoorBoth

Type: —Please choose an option—SpayedNeutered
Age:  —Please choose an option—IndoorOutdoorBoth

Type: —Please choose an option—SpayedNeutered
Age:  —Please choose an option—IndoorOutdoorBoth

Type: —Please choose an option—SpayedNeutered
Age:  —Please choose an option—IndoorOutdoorBoth

If you Rent, complete the following:

Landlord’s Name:
Landlord's Telephone Number: _555-555-1234
Does your Landlord allow pets? —Please choose an option—YesNoUnknownNot Applicable - We Own our home

A Few Additional Details

About The Adoptive Animal.

Reason for adopting the animal: —Please choose an option—Myself, As an IndividualMy Household/FamilyA Classroom, at a school where I am a staff memberAnother situation not described here

Where will your pet be kept during the day?
And at night?
How many hours will the animal spend alone each day?
Rescued Animals have sometimes been in neglectful and/or abusive situations and therefore, may experience difficulty making the transition to a new home. Are you willing to be patient while your animal adjusts to its new home? —Please choose an option—YesNo
How long do you feel an animal should be given for an adjustment period?

Do you have experience caring for the species of pet you are interested in adopting? —Please choose an option—YesNo

Do you have an exotics/farm vet you would contact if a medical need arose? —Please choose an option—No, I need a recommendation for a vet to contactYes, I have a vet I would plan to contactYes, I have a vet who has treated my pets beforeYes, I am a Veterinarian or work closely with one

Please describe the type of habitat your adopted pet(s) will be living in; If you do not know what habitat you will be using, please indicate you need a recommendation.

Please describe where in your home your adopted pet(s) habitat would be located.

Any additional notes, questions or comments you would like to submit with your application

Your Experience with Animals

Please list all pets you have owned in the past three years:

Pets Name: —Please choose an option—MaleFemale
  Species: —Please choose an option—SpayedNeutered
  What happened to the pet?

Pets Name: —Please choose an option—MaleFemale
  Species: —Please choose an option—SpayedNeutered
  What happened to the pet?

Pets Name: —Please choose an option—MaleFemale
  Species: —Please choose an option—SpayedNeutered
  What happened to the pet?

Pets Name: —Please choose an option—MaleFemale
  Species: —Please choose an option—SpayedNeutered
  What happened to the pet?

Vet Reference

Veterinarian Name:
Street Address:
City:
State:
Zip:

Phone#

Personal References

If no vet reference is available, please include at least two personal references. Family members cannot be personal references.
Name, Phone #

Have you sold, given away or surrendered a pet to a shelter? —Please choose an option—YesNo

Have you or any member of your family/household been cited for animal neglect/cruelty in the past? YesNo

( 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 an animal and Snooty Giggles Dog Rescue reserves the right to refuse any adoption.