NCIN Adoption Application

Thank you for your interest in adopting a pet rescued by Northern Critters in Need. We want to make certain that every animal adopted goes to a loving home, where it will be well cared for. Our application asks a number of detailed questions which are necessary for our screening process.

!!!PLEASE!!!! - Do not complete more then ONE APPLICATION! This is an online app, we can access anytime. You can list a maximum of 2 pets on your app or you can message the page if you see another pet your interested in. If you do not list a pet on your app, we WILL NOT contact you as we need to know which pet your interested in.

PLEASE ENSURE ALL FAMILY MEMBERS LIVING IN YOUR HOME ARE ONBOARD WITH ADOPTING BEFORE COMPLETING THIS APPLICATON. Thank You

STOP!!! If you have previously submitted an application & now see another pet your interested in, please complete an Alternate Choice Application. https://form.jotform.com/201713121658953

DATE:

NAME Of PET YOU'RE INTERESTED IN (must list as least one pet for us to be able to process your app) Please ensure you are applying for a pet fostered in your area. For example, you cannot apply for a pet fostered in Thunder Bay if you live in the Sault and vice versa. ALSO, you need to be a registered client at a vet clinic to adopt a puppy. Adults are a possibility as they are fully vetted!

VET INFO - you must be registered at a Vet Clinic to be considered to adopt a puppy. If not, please do not complete this application for a puppy. Apps for adults may be considered. Who is your Vet and have you contacted them recently? The Clinic must agree to continue with the pups vaccine series and to spay/neuter the pet in approx. 5 months.

FIRST NAME

LAST NAME

FACBOOK NAME

STREET

PO BOX NUMBER

CITY & PROVINCE

POSTAL CODE

YOUR AGE:

PHONE NUMBER:

CELL PHONE NUMBER:

BEST TIME TO CONTACT YOU BY PHONE

EMAIL ADDRESS:

NAME ON FACEBOOK

EMPLOYER:

SPOUSE'S NAME:

ABOUT YOUR HOME

TYPE OF RESIDENCE:

Condo House - Owned House - Rented Apartment Mobile Home Other

HOW LONG HAVE YOU LIVED HERE:

0-6 months 6 months - one year longer than one year

LANDLORD NAME & PHONE NUMBER:

FAMILY INFORMATION

	Name	Birthdate-m/d/y	Relationship
1
2
3
4
5
6

Are all members in agreement about adopting? IF NOT, PLEASE DO NOT SUBMIT THIS APPLICATION.

Yes No

Who will be the primary caregiver for this animal?

Who will be financially responsible for this animal?

Do any members of the househould have asthma or allergies to pets?

How often do you travel? Who would care for the pet when you are gone?

How many hours would the pet be alone each day?

0-2 hours 2-4 hours 4-6 hours 6-8 hours over 8 hours

CURRENT PET INFORMATION

	Pets Name	Breed	Age	Sex	How long owned?	Spayed or Neutered	Vaccines current?
1
2
3
4
5
6

PREVIOUS PET INFORMATION

	Pets Name	Breed	Spayed or Neutered	How long owned?	What happened?	How long ago?	Vet Clinic/Hopsital
1
2
3
4
5
6

If you have a cat, does it get along with dogs?

Yes No

If you have a dog, does it get along with other dogs?

Yes No

What Veterinary Clinic do your pets go to?

May we call to verify vaccines & spay/neuter status?

Yes No

PET HISTORY

Have you ever given a pet away, given it to a shelter or rescue group, returned it to a breeder or sold it?

Yes No

If Yes, why?

Have you ever had a pet for a short period of time and it did not work out?

Yes No

If Yes, why?

Have you ever had an animal lost or stolen

Yes No

If Yes, what happened?

Have you ever had to retrieve your animal from the pound, shelter or animal control facility?

Yes No

If Yes, why?

Have you ever had an animal die as the result of being hit by a car, being poisoned or from unknown causes?

Yes No

If Yes, what happened?

Have you ever had a pet that gave birth?

Yes No

If Yes, when & the circumstances?

Have you previously applied to adopt from Northern Critters In Need?

Yes No

Have you previously or recently applied to adopt from another rescue?

Yes No

If yes, which rescue?

Have you ever adopted from us or another rescue?

Yes No

If Yes, which rescue & details of the pet.

PLANS FOR YOU NEW PET

Will the dog live:

Indoors mostly & outside for elimination & exercise Outdoors only Outdoors only & indoors on occcasion

Where will the dog be when nobody is home?

Indoors Outdoors both

Do you have a fenced yard?

Yes No

We require you to spay or neuter any pet adopted from us. Do you agree to do this when the pet is 6 months old or asap after this age?

Yes No

Are you willing to bring your pet to a Vet for yearly exams and for vaccinations as per your vets reccomendations?

Yes No

Are you able/willing to pay for pet expenses including veterinary care, food, supplies, toys. boarding, grooming, etc.?

Yes No

Are you willing to commit to providing a home for this pet for their entire life?

Yes No

PREFERENCES

I prefer a dog that is:

small medium large any size

Energy level:

low medium high

I intend to:

walk pet on a leash walk pet off leash bring to a dog park hunt with the dog go hiking or jogging with my pet let pet exercise himself in my yard

I prefer a pet that is (please check all that apply):

Breed/mixes I prefer:

AGREEMENT

Would you be willing to have an in-home visit by a NCIN representative before or after you have adopted from us?

Yes No

Would you agree to contact us after the adoption for periodic updates?

Yes No

Are you on Facebook?

Yes No

Will you accept a friend request from one of us?

Yes No

Do you agree to contact Northern Critters In Need FIRST if you ever have to surrender this pet?

Yes No

Do you agree to pay the $350.00 adoption fee (higher fee may be applicable depending on pet and if pet is Purebred)? The fee for cats or kittens is $120.00, This fee covers the costs incurred for the pet up to the date of adoption. We will reimburse you $100.00 upon proof of spay or neuter surgery for dogs. Refund for cats is $50.00. All dogs & cats are microchipped.

Yes No

Click to edit

WE HAVE THE RIGHT TO REFUSE ANY ADOPTION APPLICATION THAT WE DO NOT SEE FIT. Please review your application before submitting as any incomplete applications will be disregarded.

Name (print):

Date:

YOUR SIGNATURE WILL BE REQUIRED UPON ADOPTION OF PET AND WILL BE ATTACHED TO YOUR APPLICATION.

THANK YOU FOR YOUR INTEREST IN NORTHERN CRITTERS IN NEED. A REPRESENTATIVE WILL CONTACT YOU WITHIN A FEW DAYS OF APPLICATION SUBMISSION. IF YOU WISH TO INQUIRE ON THE STATUS OF YOUR APPLICATION, YOU MAY SEND A MESSAGE TO THE PAGE

Previously unsuccessful applicants were sent a text. This has stopped and it will now be up to the applicant to message the Facebook page if they wish to know the status of their app.

Signature

NORTHERN CRITTERS IN NEED - ADOPTION APPLICATION