Adoption Application – St Francis Rescue Nacogdoches

- Step 1 of 6

Please contact us if you have any questions while completing this form. Call or text (936) 615-7425 or send email to adopt@stfrancisrescuenac.com

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Day Phone *

Evening Phone *

Email *

What is your age? *

18-20
21-25
26-30
30+
Over 65

Please contact us if you have any questions while completing this form. Call or text (936) 615-7425 or send email to adopt@stfrancisrescuenac.com

It is my intention to integrate any animal I may adopt into my home and life as a pet and companion. I understand that adoption entails a commitment to provide responsibly for the pet's needs for the rest of its life. I am over age 18 and I am ready to make this commitment. *

Please read and initial

I am aware that pets adopted from St. Francis Rescue Nacogdoches are current on all vaccinations at the time of adoption, and that they and all other pets in the adopter's home must be kept current on vaccinations. *

Please read and initial

I am aware that my pet may live 15 or more years; that a pet’s basic needs alone cost hundreds of dollars per year; that my pet will require time each day for training, grooming, exercise, and interaction. *

Please read and initial

I am aware that if at any time for any reason I am unable or unwilling to care properly for this pet, I am to return him/her to SFRN. Under no circumstances will I give away or sell this pet. *

Please read and initial

I am aware that all pets adopted from SFRN must be spayed or neutered, and that all other pets in the adopter’s home must also be spayed or neutered. *

Please read and initial

Please contact us if you have any questions while completing this form. Call or text (936) 615-7425 or send email to adopt@stfrancisrescuenac.com

If you have looked at the pets we have available for adoption online and are interested in a specific one, what is his/her name?

What pets are currently in your household?

Pet #1

Name (Pet 1)

Type (Pet 1)

Is this pet Spayed or Neutered? (Pet 1)

Where is this pet kept? (Pet 1)

Inside
Outside
In/Out

Breed (Pet 1)

Sex (Pet 1)

Male
Female

Age (Pet 1)

How many years have you had this pet? (Pet 1)

Pet #2

Name (Pet 2)

Type (Pet 2)

Is this pet Spayed or Neutered? (Pet 2)

Where is this pet kept? (Pet 2)

Inside
Outside
In/Out

Breed (Pet 2)

Sex (Pet 2)

Male
Female

Age (Pet 2)

How many years have you had this pet? (Pet 2)

Pet #3

Name (Pet 3)

Type (Pet 3)

Is this pet Spayed or Neutered? (Pet 3)

Where is this pet kept?

Inside
Outside
In/Out

Breed (Pet 3)

Sex (Pet 3)

Male
Female

Age (Pet 3)

How many years have you had this pet? (Pet 3)

Pet #4

Name (Pet 4)

Type (Pet 4)

Is this pet Spayed or Neutered? (Pet 4)

Where is this pet kept? (Pet 4)

Inside
Outside
In/Out

Breed (Pet 4)

Sex (Pet 4)

Male
Female

Age (Pet 4)

How many years have you had this pet? (Pet 4)

Please contact us if you have any questions while completing this form. Call or text (936) 615-7425 or send email to adopt@stfrancisrescuenac.com

List your previous pets & describe why you no longer have them.

Previous Pet #1

Name (Previous 1)

Type (Previous 1)

Was this pet Spayed or Neutered? (Previous 1)

Where was this pet kept? (Previous 1)

Inside
Outside
In/Out

Breed (Previous 1)

Sex (Previous 1)

Male
Female

Age (Previous 1)

How many years did you have this pet? (Previous 1)

Briefly explain why you no longer have this pet. (Previous 1)

Previous Pet #2

Name (Previous 2)

Type (Previous 2)

Was this pet Spayed or Neutered? (Previous 2)

Where was this pet kept? (Previous 2)

Inside
Outside
In/Out

Breed (Previous 2)

Sex (Previous 2)

Male
Female

Age (Previous 2)

How many years did you have this pet? (Previous 2)

Briefly explain why you no longer have this pet. (Previous 2)

Previous Pet #3

Name (Previous 3)

Type (Previous 3)

Was this pet Spayed or Neutered? (Previous 3)

Where was this pet kept? (Previous 3)

Inside
Outside
In/Out

Breed (Previous 3)

Sex (Previous 3)

Male
Female

Age (Previous 3)

How many years did you have this pet? (Previous 3)

Briefly explain why you no longer have this pet. (Previous 3)

Previous Pet #4

Name (Previous 4)

Type (Previous 4)

Was this pet Spayed or Neutered? (Previous 4)

Where was this pet kept? (Previous 4)

Inside
Outside
In/Out

Breed (Previous 4)

Sex (Previous 4)

Male
Female

Age (Previous 4)

How many years did you have this pet? (Previous 4)

Briefly explain why you no longer have this pet. (Previous 4)

Please contact us if you have any questions while completing this form. Call or text (936) 615-7425 or send email to adopt@stfrancisrescuenac.com

Veterinarian Information

Name of Veterinarian *

Veterinarian's Phone Number *

Name records are under if different from applicant

I authorize the veterinarian listed above and their agents to release to SFRN any information pertinent to evaluating my history of pet ownership, if any. *

Initals

Residence Information

How many years have you lived at this address?

Do you live in a *

House
Apartment
Duplex
Townhome/Condo
Mobile home

Are you planning to move soon? *

Do you own or rent? *

Own
Rent

Name of Landlord

Landlord's Phone Number

I authorize my landlord (if any) and their agents to release to SFRN information in my rental agreement that pertains to pet owning and keeping.

Initals

How will you keep your pet confined when outdoors (check all that apply)? *

Fence
Kennel Run
Patio
Garage
Leash
Chain/Tieout/Runner
Other (Fill in next blank)

If you answered Other above, explain here.

If you answered Fence above, How tall is the fence?

If you answered Fence above, What type of fence is it?

Please contact us if you have any questions while completing this form. Call or text (936) 615-7425 or send email to adopt@stfrancisrescuenac.com

Other Information

How will you prevent your dog from getting heartworms? *

Are you familiar with your local city regulations requiring pets to be licensed every year? *

To provide food, medical care, registration and grooming for this pet, how much do you anticipate spending yearly? *

$200
$300
$400
$500
$600
$700 or more

If you suddenly relocated or had other drastic lifestyle changes that made it hard to keep your pet, what would you do with him/her? *THE PET WILL BE RETURNED TO SFRN* *

Initial

If the pet becomes seriously ill or injured and your veterinarian says expensive medical treatment is needed, what will you do? *

Number of adults in your household *

Number of children and their ages *

Is anyone in your family allergic to dogs or cats? *

If so, how will you accommodate? *

How many hours per day will this pet spend alone? *

Why? *

Where will you keep your pet when you are at work? *

Where will you keep your pet at night? *

What will you do if your pet is destructive? (digs, chews, claws furniture, etc.)? *

Do you know you may have to obedience and/or housetrain your pet, which may require time and patience, and are you willing to commit to any necessary training? *

With your current or previous companion animals, have you dealt with behavioral issues such as separation anxiety or fear of thunderstorms? *

If yes, what did you do to resolve them?

What specific traits are you looking for in a dog or cat (i.e. crate trained, good with other dogs/cats, etc.) *

How will you exercise and interact with your pet? *

Why do you want to adopt this particular pet/breed? *

Does everyone in the family want to adopt this pet? *

Would you object to a home visit from a representative of SFRN prior to adoption? *

Would you object to a follow-up call from SFRN? *

I certify that the above information is true. False information will be cause for denial of this application. SFRN reserves the right to deny any adoption for the sake of the animal’s welfare. All completed applications are the property of SFRN and will be retained in their files.

Type your full name if you agree. *

Date