ERIE SHORES HUMANE SOCIETY

Adoption / Foster Application

Please answer the following questions to help us understand your background and the type of home you will be providing to our animals.The application will be reviewed and an Erie Shores Adoption/Foster Coordinator will contact you regarding the application. Your privacy is important to us. Information you provide on this form will remain confidential.

Fields marked with a * are required.

All Questions should be filled out Completely

* First Name:

* Last Name:

* Address:

* City:

* Zip Code:

* Phone - please include area code:

Work or Cell - please include area code:

* Email:

* Are you 18 years of age?

Household Information

* Type of Home:

* Do you own or rent?

* Landlord Name (if none type none):

* Landlord Phone - (if none type none) - please include area code:

* Do you plan on moving in the next 6 Months?

* Do you have children?

* If Yes above - Childrens age? -

* Do you have Grandchildren or other Children visit?

* Will the children be supervised around the animals?

* Name of all Adults who live in the household? (if none type none)

* Does anyone in the household have an allergy to animals?

* Does anyone in the household have a fear of animals?

* How would you describe the activity level in your home?

* How many hours a day are you away from home?

PET Information

* Does your home have a fence?

***note - If there is no fence, dogs MUST be on a leash and supervised while outdoors.

*Cats are adopted out as indoor companions only.

* Do you currently have any pets?

* Please provide the breed of your current animals, their ages, and their temperament with other animals:

* Are the animals spayed/neutered and current on vaccines?

* Please provide the name of your current veterinarian or clinic.

* Do you give Erie Shores permission to contact your vet?

***Note - YOU WILL NEED TO CONTACT YOUR VET ASAP TO VERBALLY APPROVE A RELEASE OF INFORMATION TO ERIE SHORES.

Past Pet Information:

* Have you owned a pet in the past?

* Please provide the reason you no longer have the pet(s):

* How long did you have the pet(s) for?

* Have you ever relinquished an animal to a rescue or pound?

* If yes, please specify reason

* Have you ever had a pet run away from home?

* Have you ever had a pet that passed away unrelated to natural causes? Please specify:

* Have you ever needed to declaw a cat in the past?

* Do you understand the financial, psychological and the time responsibility of owning a pet?

* Name of the pet you are interested in?

* Please provide at least 2 references:

* Please Type Your FULL Name:

* By choosing Yes you agree that this typed name is your signature from above box:

Enter Code Here: