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Pet Adoption Form

Name:
Address:
E-mail

Contact Numbers
Home:
Work:
Mobile:

General Information
Age:
Marital Status
No. of Children:
Ages:

Number of Non-Related Residents
Housemates:
Maid
Other:

Residence
Own Rent
City:
Village:

Questionnaire

1. Are you willing to permit home-check by pet rescuer in case you adopt a rescue case?
Yes No

2. How many hours will your pet be left alone per day?

3. Do you or anyone in your family have allergies to hair or dust?

4. Do you have pets in your household now?
4a. How many?
4b. Type?
4c. Are your other pets spayed/neutered?

5.Would you adopt a pet that has health problems?

6. Are you prepared for the ongoing responsibility and expense of vet visits?

7. What type of pet do you want?
Dog     Cat Other

8. What pet age appeals to you?
7 weeks:   12 weeks:    Young adult:    Older:

9. Are you looking for a specific breed?

10. Why do you want a pet?
Protection:    Friendship:    Hunter:    Breeding: Child’s Friend:    Show or Contest:    Specific Training:

11. Are you willing to spay or neuter your pet?

12. If you could order a pet from a catalog, you would say:
I'm looking for a pet who is ...

13. Are all members of your household aware that you are acquiring a pet?
Do they all approve?

14. What happened to your last pet?
Ran away Stolen Sold Given away Died Still Alive

15.Are you planning to relocate home, city, or country of residence soon?
Yes No

16. Will your adopted cat/dog live indoors or outdoors?
Indoors     Outdoors

17.Please describe a typical day in the life of your adopted animal:

18.How did you hear about us?
Search Engine Another Adopter Another Website Other

19. Please provide additional Information:



I agree to return the adopted animal to the custody of BETA in case of mistreatment, neglect, exploitation, or in case I cannot or do not want to keep it anymore.

 
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