Pet Adoption Questionnaire Animal you’re interested in adopting Breed Applicants Information Name Email Street Address City State Zip Home Phone Cell Work Driver's License # State Issued ---ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Do you own or rent your home? ---OwnRent Landlord’s name if applicable Landlord’s Phone If renting, have you spoken with your Landlord and have permission to have an animal and paid any necessary pet deposit? ---YesNo How long have you lived at this address? ---Less then a year1 Year2 Years3 Years4 Years5 Years6 Years7 Years8 Years9 Years10 Years or More Is your yard fenced? ---YesNo Do you plan to move within the next 6 months? ---YesNo Explain (If Yes) If moving, do you plan to take your new pet with you? ---YesNo Your Animal History How many companion animals do you currently live with? Breeds & ages if applicable Kept inside or outside? if applicable ---InsideOutside How long have you had each? if applicable Are you animals currently vaccinated? ---Not ApplicableYesNo Who is your Veterinarian? Phone May we visit your home prior to adoption? Again in 6 or 12 months? ---Yes / YesYes / NoNo / YesNo / No Do you plan to declaw (cat) or crop ears or tail (dog)? ---YesNo Do you agree to contact us at VOCAL @ BeVocal.org or 850-668-5999 should you find you are unable to care for your adopted pet for any reason? We are here to help you! Yes, I Agree I certify that the information I have provided is true and correct. I understand it is VOCAL's mission to unchain all dogs and should I choose to chain this animal I’ve adopted at any time in the future for any reason I’m giving VOCAL the right to confiscate this animal immediately. Yes, I Certify
