Lake Haven Online Pet Adoption Application

 

Online Application Instructions: Please fill out the application below.  Only those applications that are completely filled out are able to be processed.  If you would like to see the terms of the application again, please click here.

 

 

Application Intent

 

What are your intentions for filling out this application?
I would like to MEET a pet for potential adoption

I have already met my pet of choice and am READY TO COMMIT

Name of pet you are interested in adopting:

 

Contact Information

Please provide the following contact information:

First Name:   Last Name:  

Street Address:   

City: State: Zip:

Work Phone: Home Phone:  

Email Address:

Alternate Email Address:

(note: Please double check your email address for accuracy. We will use this address to reply to you.  If you mistype the address, you will not receive our reply. Please, only one email per line.) 

 

Housing Accommodations

Please list all people living in the household�  include names, ages and relationship to applicant.:

Do you own your current home?
Yes
No

              

What type of home are you currently living in?  (Note - living in an apartment, mobile home or condo WILL NOT disqualify you from adopting a pet as long as you are available to meet that pet's individual needs.)
House
Apartment

Condo

Mobile home

IF RENTING, please describe any restrictions on pets... size, breed, (declawed) cats, etc.

How long have you been renting? (approximate years, months).

 

 

Employment Information

 

Are YOU currently employed?
Yes
No

IF YES, list your current employer and how many years you have been employed.

 

If there is another adult head of household, is that person currently employed?
Yes
No

IF YES, list current employer and how many years they have been employed.

 

 

 

 

Pet Accommodations

 

Where will your new pet stay when you are away?

How many hours a day do you anticipate your pet being home alone?

Where will your new pet sleep at night?

  

If you are applying for a DOG or PUPPY:

How will the dog be let out to relieve itself? (Select all that apply)

Fenced yard

Leash walk

Free roam

Tie out cable

Kennel run

Loose with supervision

Other (please explain below)

IF "OTHER" above, please explain.

Are you familiar with crate training? 

Yes
No

Do you intend to use a crate? 

Yes
No

 

Do you currently have a crate? 

Yes
No

     

If you are applying for a CAT, will the cat be allowed outdoors?
Never
Yes

Overnight

As it wishes

 

Current/Previous Pets

Please list all pets currently living in your home.  Include name, breed, age, and how long you have had them.

Please list all pets you have previously owned.  Include name, breed, and why you no longer have them.

 

Are your current pets spayed/neutered?
Yes
No

 

Are your present pets current on vaccinations?
Yes
No

If you currently have dogs, have they been heartworm tested?
Yes
No

If you currently have dogs, are they on heartworm prevention?
Yes
No

If your answer to the previous questions for any of your current pets was "No", please explain.

 

Veterinarian Information

Please provide the following veterinarian information.  (REQUIRED: Make sure you have contacted your current vet and requested a "release of information" to Lake Haven before submitting this application.  This authorizes your vet to talk to us.  We are unable to process applications without speaking to your current or most recent vet.)

Veterinarian's Name:  

Hospital/Clinic Name:

Street Address:  

City: State: Zip:

Phone: Fax:  

 

If you have used any other veterinarian, please list names and phone numbers below.  Include which pets they treated.

 

Additional Considerations

  

Please share additional comments or considerations that you would like us to know:

 

Lake Haven Website

How did you hear about Lake Haven's website? (select all that apply)

Lake Haven volunteer

At PetSmart

Attending Saturday Adoption Day (at PetSmart)

PetFinder.com

Craigslist.com

General Internet search

Other

 

IF "OTHER" above, please explain.

 

Please review your application now before you submit.  Please only click the submit button once.