Apply to Adopt Thank you for considering pet adoption! Fields marked with * are required. You can use the online form, or download and print this form, fill it out and return it to the address listed at the top. Your Contact InformationFirst Name *Last Name *Phone number *Please list the best phone number at which to reach you.Address AddressAddress Line 2CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepaNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabweCountryEmail Adoption QuestionsIf you are interested in a specific animal, please provide the name here: Are you familiar with this breed? YesNoN/A (no specific animal chosen)If you have not listed a specific animal, what type are you interested in adopting? Please check all that applyDogCatOtherWhat age pet are you considering for your family? Please check all that applyBaby (puppy or kitten under 6 months)Young (6 months - 2 years)Adult (2 years - 5 years)Mature (over 5 years old)Have you owned a dog or cat before? YesNoWhy do you want to adopt a dog or cat? How long have you been considering pet adoption? Do all members of your household want a pet at this time? YesNoNot surePlease tell us what happened to your last pet (deceased, rehomed, etc): Where will your new pet sleep at night? How many hours per day will your new pet be alone? How much are you able and willing to spend on this pet annually? If you moved, what would happen to this pet? What reason(s) might cause you to give up a pet? Have you visited any local shelters or rescues? YesNo, I'm looking online onlyWhich of the following currently live in your home? Please check all that applyDog(s)Cat(s)One or more childrenPlease use this area to list the name, age, and sex of each person living in your household: Do you own or rent your home? If you rent, please fill out the section at the bottom of this form labelled Rental Information.OwnRentWould you consent to a home visit from Special Pets Rescue prior to adoption? YesNoIf we are unable to arrange a home visit, are you willing to email us photos of your yard and planned sleeping area for your new pet? YesNoWho will care for this pet in your absence? For Dog Adopters OnlyDo you have a fenced yard? YesNoIf yes (above), how tall is the fence at its lowest point? What is the fence made of? Are you willing to attend obedience classes? YesNoHave you ever crate trained a dog before? YesNoAre you willing to crate train your new dog? YesNoIf you currently own a dog, is your dog on heartworm preventatives? YesNoDo not have a dogIf yes (above), what brand of preventative? Emergency Caregiver InformationPlease provide the name of someone who would care for this pet if you could not, either permanently or for an extended period of time: Please provide a phone number for this emergency caregiver: Veterinarian InformationYour veterinarian's name: Your veterinarian's phone number: Rental InformationIf you rent, please provide the name of your landlord: And the phone number of your landlord: VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank: