The online application may be completed and sent, if it is successful you will see a confirmation page with the information that was input. If you prefer underneath the online application is one that can be copied and pasted into an email.
P.O. Box 940877
Houston, TX 77094-7877
A successful adoption that matches the requirements and expectations for the perspective family and the pet depends on selecting the right pet for your household. It is also important to understand the needs and requirements of the pet. Please help us with this process by answering the following questions as fully as possible.
ADOPTION Saving Lives!
The following application may be copied and pasted into your document folder and then inserted into an email.
Name of Applicant:
Name of Co-Applicant:
Driver License #
Home Phone: Cell Phone: Work Phone:
Best Number and Time of Day to Contact:
Applicant Occupations and work schedule:
Are you aware that routine costs to maintain a pet average $500.00 to $800.00 dollars a year? Yes________ No_______
Please list all members of Household excluding pets and ages of each:
Please List all pets in Household:
Are all pets in the household spayed and/or neutered: Yes_____ No_____
If answered No, please indicate status of pet:
Are all dogs in your household on year round heartworm preventative?
Yes_______No______ Name of Preventative:____________________________
Other than children living in the Household, will your pet come in contact with other children under the age of 5 (i.e. neighbors, grandchildren)?
Yes___________No__________ If yes, what ages?______________________
Do any elderly or physically challenged people live with you or visit frequently?
Is the house that you live rented or owned?____________________________
If you rent, do you have your landlords permission to own a pet?____________
May we contact your landlord to verify permission? Yes________No_________
Name of Landlord:___________________________________________________
Do you have a fenced yard? Yes_______No___________
Please describe fence (height, condition, etc):____________________________________________________________________________________________________________________________________________
Do you have a Dog Door: Yes_________No_________
INFORMATION ABOUT YOUR HISTORY WITH PETS
Will this be your first Pet? Yes_______No_________
What breed(s) of Dogs have you been companion to?
Have you ever bred a pet? Yes________No________
Have you ever sold a pet? Yes________No________
Have you ever given a pet away? Yes________No__________
Have you ever surrendered a pet to a shelter? Yes_______No___________
Please explain circumstances if Yes to any of the preceding questions
Do all Members of the family want a Pet? Yes________No_______
Please tell us the reason you want a Pet.
Why do you think you would be a good caregiver to a pet?
________________________________________________________________________________________________________________________________________________What What age pet fits with your lifestyle and expectations?_________________________
Are you aware that some pets are very active? Yes________No________
Do you have time and are physically able to give active pets adequate excersise?
Are you aware that all pets shed year round? Yes________No_________
Is anyone in your home prone to allergies or may be adversely affected by a pet?
Describe activities that your pet would be included (i.e. swimming, family outings)
Is anyone home during the day? Yes____No____ Age_______
How long will the pet normally be left alone during the day?____________________
Where will the pet be kept during the day when no one is home?___________
When you transport/travel with your pet, will they ride in a car, truck or both?
If you answered truck or both, how will you restrain your pet to prevent accidents such as falling out or being tossed out?_________________________________
__________________________________________________________________ What provisions can you make for your pet if you become sick or hospitalized?
________________________________________________________________________________________________________________________________________________________________________________________________________________________What What will happen to the pet if you get married, get divorced or have children?
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________If If you move, what will you do with your pet?_________________________________
________________________________________________________________________________________________________________________________________________Are Are you familiar with the use of a dog crate to confine the pet during any absence, for their safety, as an aide in housebreaking or to provide a safe haven?_________________________________________________________________________________________________________________________________________________________________________________________________________________Where Where will your pet sleep at night?__________________________________________
Please check all the following that will apply to your pet:
Will your pet:
Have the run of the house? Yes_______No_______
Be in blocked off parts of the house? Yes________No_________
Be crated? Yes______No______
Be tied outside? Yes________No________
Live in a fenced back yard? Yes__________No________
Live mainly in a dog run? Yes________No________
Roam loose in the neighborhood? Yes________No_________
If you are adopting a cat, will the litter box be kept inside? Yes______No______
Will the cat be declawed? Yes________No_________
Will the cat be allowed to go outside? Yes_______No________
Loving Arms Pet Placement believes it is important to be aware of laws governing the ownership of a pet. Are you familiar with your local, county and state laws?
INFORMATION ABOUT THE POST APPLICATION PROCESS
May we visit your home prior to application approval? Yes_____No_____
Please indicate the best day and time for a home visit:__________________________
May we contact your veterinarian? Yes_______No________
If yes, provide contact information of most recent vet:
Our volunteers may take up to two weeks to complete the application process, are you willing to wait? Yes_______No_______
Loving Arms Pet Placement will require a $100.00 donation if application is approved. Are you able to pay this amount? Yes______No________
Answers are expected to be complete and truthful, as they will enable us to better comply with your requests and requirements. Failure to provide accurate information can result in revocation of the adoption at any time by Loving Arms Pet Placement. By completing this form the undersigned(s) expressly give permission to Loving Arms Pet Placement to verify the information contained in this application, and further release Loving Arms Pet Placement from any and all liability associated with this application or the adoption process.
I/We attest that the Terms and Conditions of Adoption, as stated above, have been read in full by Me/US and I/We understand that these terms constitute a part of the adoption agreement between Me/Us and Loving Arms Pet Placement and will be enforced.
Terms and Conditions have been read? Yes_______ No_______
I/We attest that information provided on this application is true and accurate to the best of My/Our knowledge. I/We understand that completion and submission of this application does not guarantee adoption of a pet. If application is submitted electronically, I/We further attest that no changes have been made to the content of this document and understand that my approval by signature is assumed and agree to transmit a signed original or facsimile prior to any decision by Loving Arms Pet Placement on my adoption application.
Co Applicant Signature:_______________________________________Date_________
Thank you for your interest in providing a loving and permanent home to a Loving Arms Pet Placement Pet.
Submission of an adoption application does not guarantee an adoption of a pet through Loving Arms Pet Placement.
Thank you for opening your home and heart to a rescued pet.