SAVING LIVES ADOPTION APPLICATION
Today’s Date: ______________________________
Name: ________________________________________________________________
Address: _______________________________________________________________
City: ____________________________ ST: _____________ Zip: __________________
Home Phone: ________________________ Cell Phone: _________________________
Email: _________________________________________________________________
Are you interested in adopting a
Do you live in a
 House
 Dog  Cat
 Apt
 Condo
 Mobile Home
How long have you lived at your present address? ______________________________
Do you anticipate moving in the future? _______________________________________
Number of adults in your household ____________ Children _____________
Ages of Children: _________________ ________________ ____________________
Do you have a fenced yard?
 Yes
 No
What type of fence?  Chainlink  Block Wall  Wood  Other _______________
How tall is the fence? _____________________________________________________
Do you:  Own  Rent
Does your landlord authorize you having this pet? _______________________________
Do you have a dog door?
 Yes
 No
Is it open when you are gone/sleeping?
 Yes
 No
Where will your pet be kept during the day? ____________________________________
Where the pet be kept at night or when you’re gone? _____________________________
Will this be your first pet?
 Yes
 No
S.A.I.N.T.
P.O. BOX 22411 • Bullhead City, AZ 86439 • T: (928) 704-0800 • E: [email protected] • www.BHCSaint.Org
SAVING LIVES ADOPTION APPLICATION
Name and Phone Number of your Veterinarian:
___________________________________________________________________
Do you currently have other pets? Please fill in the area below for each pet.
Pet’s Name
Age
Spay/Neutered
Current on Vaccinations?
I agree to abide by the terms and conditions below with respect to this adoption application:
1.
I PROMISE to make a reasonable commitment of time and effort to make this new
relationship work.
2.
I PROMISE to provide appropriate and timely veterinary care for the life of my new dog.
3.
I PROMISE to provide my new dog with the proper nutrition for optimum health and to keep
my new dog the proper weight, neither obese nor emaciated.
4.
I PROMISE to keep my new dog indoors at night, and to include him/her in the activities of
the household while I am home.
5.
I PROMISE to keep my new dog groomed and free of parasites & matting.
6.
I PROMISE to offer my dog mental stimulation in the form of either play, interactive toys,
training or daily walks.
7.
I PROMISE to provide a home in which my new dog clearly knows what the rules of the
house are & that I will insist they be followed so my new dog can learn to trust me & count
on me.
8.
I PROMISE to provide my new dog with enough chew toys to satisfy his/her urge to chew.
9.
I PROMISE to get professional help if you dog has or develops behavior or temperament
problems, and, if safe, to manage my new dog carefully so as not to endanger the people
and other pets in my home & community.
10.
I PROMISE to do everything I can to keep my dog from becoming a nuisance in my
community.
11.
I PROMISE not to allow my new dog to run free/out of control, chase cars, bicycles,
children, etc.
12.
I PROMISE that if I have to move residences for any reason, I am aware that finding
housing that accepts pets can take longer than average, but that I will commit to moving
with my dog, as I would move with any other member of my family.
13.
I PROMISE that if, for any reason, I can no longer keep my new dog, I will not abandon this
dog, surrender him/her to any public shelter/animal control or give this dog to anyone
other than the S.A.I.N.T. Saving Lives Foster & Adoption Program.
By signing below, you agree that you have read and understand the Adoption Application terms and
conditions listed above.
Signature:
Printed Name:
S.A.I.N.T.
P.O. BOX 22411 • Bullhead City, AZ 86439 • T: (928) 704-0800 • E: [email protected] • www.BHCSaint.Org