Nature's Way Animal Rescue and Rehabilitation

Online Adoption Application

Adoption fee: Donations would be greatly appreciated!

Name

Street

City State Zip

Home Phone

Cell Phone

Work Phone

Spouse Employment

Spouse Work Phone

Do you live in:
House
Apartment
Mobile Home

If you rent our home or property, does your lease allow pets?
yes
no

Landlord Name

Landlord Number

Do you have a copy of your lease stating that you are permitted to have pets?
yes
no

Are there any restrictions concerning pets?
yes
no

List everone at this address:
Adults (age 18 or older)

1. Name

Relationship

2. Name

Relationship

3. Name

Relationship

Children (under age 18):

1. Name

Relationship

2. Name

Relationship

3. Name

Relationship

Is anyone in the household allergic to cats or dogs?
yes
no

List other animals in your home:

Species	Breed	Sex	Spayed or Neutered?	Age	Time Owned

Are your pets:
Indoors
Outdoors
Both

Do you have a fenced in yard?
yes
no

Do you have a doggie door?
yes
no

How many hours a day are your pets left alone?

You are adopting an animal that has been rescued and therefore is deserving of a final and loving home. By adopting this animal from Nature’s Way Animal Rescue and Rehabilitation, Inc. I am agreeing to the following conditions and financially able to:

1. provide a compassionate and loving home for the rest of this animal’s life
2. protect this animal and take full responsibility for his/her behavior
3. if for some reason I am unable to continue to care for this animal, I will return him/her to Nature’s Way Animal Rescue
4. allow Nature’s Way a 30 day, 6 month and 12 month home visit to check on the animal’s living conditions
5. allow Nature’s Way to also be listed on the Avid Chip registration list for emergency contact
6. ABSOLUTELY will NEVER engage this animal in any form of animal fighting!
7. Animal will be spayed/neutered no later then 5 months of age, if non-compliant, animal will be repossessed by Nature’s Way.
8. will not hold Nature’s Way liable for any damage or injury caused by this animal.

If you agree to the above, inital here:

Other important information concerning this specific animal:

Previous/Current Veterinarian

Veterinarian Phone Number

Personal Reference

Reference Phone Number

Relationship