Adoption Application

PO Box 1743 | Melrose, FL 32666 | (352) 478-1444

puppyhill@hotmail.com

Please fill out the form below and click "Submit"

NOTE: Submitting this application does not imply approval for adoption. Prospective adopters need to go through the adoption interview process at a regularly scheduled adoption event.

All items marked with ^* are required to submit this application



^*First Name
Middle Initial
^*Last Name
^*Address Line 1
Address Line 2
^*City
^*State
^*Zip Code
^*Low long have you lived at this address?
^*Email Address
^*What is the name of the animal that you are applying for?	(If you can't remember the name, click here to see our list.)
^*Home Phone
Mobile Phone
^*What is your date of birth?
^*Who is your current employer
Work Phone
How did you hear about us?
^*How long have you been thinking about adopting a new pet?
^*What other animals live under your care? Please list species, breed, and age of each animal, and any relevant details.
^*Are your pets indoor or outdoor pets (including the one that you would like to adopt)?
Who is your current veterinarian (if applicable)?
What is your veterinarian's phone number?
How long have you used this vet?
^*How much money do you expect to spend on a pet in the first year?
^*Please choose select at least one item from the list that describes your property:	Fenced Yard Screened Porch Open yard with no fence Condo/Housing Complex/Apartment Complex Other (please describe below)
Please give us some more details about your property: specifically where your pet(s) will interact.
^*Please name all other residents that live in your household.
^*In the unfortunate event of death or you becoming unable to care for the pet, please list names of people who would be their caretakers.
^*Please list previous pets that you have owned and where they are now.
^*Do you rent or do you own?	Rent Own
^*Who is your landlord? If you own, please put "self".
What is your landlord's phone number?
^*To help us prevent spam, please type the two words (may contain nonsense words and/or numbers) that you see in the blank, each separated by a space:

Please help us save lives….one life at a time.

NOTE: Submitting this application does not imply approval for adoption. Prospective adopters need to go through the adoption interview process at a regularly scheduled adoption event.

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