Adoption Application

Is EVERYONE in the household in agreement to adding a new pet to the family?

Yes

Please provide a reference that is not related to you: *

How many times have you moved in the past 5 years?

Thank you for your desire to make a difference in the life of a pet in adopting! Please complete the form below and click the SUBMIT button at the bottom. If any required fields are indicated by a red asterisk. Please scroll back up and provide all required fields and then re-submit the application. Once your application is successfully submitted, a thank you message will appear on your screen. Please allow us up to 2 weeks to respond due to we are all volunteer based and we all have full time jobs.

Your full home address: *

Please provide your vet's contact information:: *

What provisions will be made for your pet when you go on vacation?

Do you presently reside with any other co-applicants, which are adults that have a role in household decision making? *

Do you rent or own? *

What is your profession and employer? *

Do you agree to provide an adoption fee to help cover our costs of spay/neuter, all shots, microchip and transport, and other related expenses? The fee can range from $250 to $500 depending on age and circumstances. *

Yes, I agree

No, I cannot afford an adoption fee

Do you have a fenced in yard?

Yes, Chain link

Yes, stockade

Yes, Other

Are your pets on heart worm preventative?

Yes

I certify that the information I have provided on this form is true, correct, and accurate. *

Yes

Have you ever had to retrieve your animal from a pound, shelter or animal control?

Yes

I understand that my electronically-provided signature [below] is valid as a means of legal signature for the purpose of this foster/adopt application and that a background check may be performed. *

Yes

Co-applicant's phone

Are all current pets up to date on vaccinations?

Yes

N/A

Provide a second reference that is not related to you: *

Have you ever had an animal lost or stolen?

Yes

Do you agree to provide KC Pet Rescue with occasional updates and/or photos of your pet in the future?

Yes

What would you do if you moved to a residence where pets are not permitted?

Your Date of Birth: *

How many adults live in this household?

What provisions will be made for your pet if alone:

Are you willing to provide photos of your home?

Yes

Your Email: *

What type of home do you reside in? *

Tell us why you wish to add a new pet to your family?

If you have had a pet and it didn't work out, please explain?

I certify that I am financially and physically able to care for the animal that I adopt. *

Yes

I hereby understand and agree that my new pet will NOT be immediately introduced to existing pets in the home upon arrival. I understand that my new pet will need ample time for decompression and KC Pet Rescue can provide literature on proper methods and time periods for decompression as well as how to properly introduce a new pet to existing pets so there will not be any conflicts. *

Yes

Date and time *

I understand and agree that falsification of any of the above information is grounds to disqualify and/or nullify this application. *

Yes

If any are not spayed or neutered, please explain why:

Is this your first pet?

Yes

Co-applicants date of birth:

Type full name to electronically sign: *

Your Full Name: *

What activities you plan to do with your new pet?

Cell Phone *

Have you ever had a pet for a short period of time and it didn't work out?

Yes

Co-applicant's place of employment:

Current & Previous Pet Information Please tell us about all pets that are currently living in your home? (N/A if you have no current pets)

Have you ever given a pet away, given it to a shelter or rescue group, returned it to a breeder or sold it?

Yes

How long have you lived at this current address?: *

Type your initials: *

Are all current pets spayed and/or neutered?

Yes

N/A

Co-applicant's Email

Check here to receive email updates

Provide a third contact (can be related): *

How many children and ages, live in this household?

If you are renting, we are required to obtain your landlord’s permission prior to placing a pet at your residence. Please provide us with your landlord’s name and contact info:

Which pet are you interested in adopting?:

Under what circumstances have you ever or would you ever give up your pet?

I hereby understand and agree that should there be any extenuating circumstances where I am unable to keep the new pet, I will immediately contact KC Pet Rescue for further instruction and I hereby agree to allow UP TO THREE WEEKS for KC Pet Rescue to retrieve the animal, during which time I understand I may need to keep the animal separated from existing pets and or children in the home if any conflicts have arisen. Under NO circumstances will I rehome the pet, drop the pet off at a shelter or with animal control, or tie or release the pet outdoors. *

Yes

I understand that KC Pet Rescue is under no obligation to place an animal with me, now or in the future. *

Yes