ADOPTION APPLICATION FORM

Name

First NameLast Name

Date of Birth

Spouse's name, domestic partner, or partner

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Your occupation

Do you own or rent your home?

What type of home do you live in? (Single family, condo, etc)

How many adults are there in your household and their relationship to you?

How many children (ages)?

Please give us three references and their phone numbers and authorization to call them. Thank you.

Please describe your household (like active, noisy, etc)

If you rent, please give rules governing pets and the landlord's name and phone number

(By providing this information, you are allowing AWM to contact your landlord. Please inform them of this call so they will speak with us.)

Have you adopted a pet before? if yes, what rescue or shelter?

Does anyone in the family have a known allergy to dogs or cats?

Is everyone in agreement with the decision to adopt a dog or cat?

Do you have time to provide love and attention?

Are you willing to allow one of our representatives to visit your home by appointment?

Please explain if you have other pets and if they are spayed/neutered. If not, why?

Please explain if you ever had a pet euthanized or surrendered and why

Have you ever lost a pet to an accident?

How do you discipline your pets and why

Do you have a veterinarian? if so, please provide his/her contact information.

Please let us know the ideal cat or dog that you wish to adopt, specify if you want a male, female, breed, etc.

Are you willing to adopt a dog/cat with special needs?

Where will the dog/cat spend the day or night? Please describe.

Are you able to afford medical care, proper diet, shelter, training, grooming, and exercise for your new pet?

Please let us know who will be responsible for the dog/cat daily care, financial responsibility, and health care.

Are you able to provide a long-term commitment to care for your pet for its entire life span, which could be as much as 10 to 20 years?

Do you agree to contact Karina Macias if you can no longer keep this dog/cat?

If you can no longer care for the animal due to long-term illness, hospitalization, death, etc., do you have a designated person that can contact Karina Macias to inform the rescue of your current situation so that the pet can be returned to us? Please list that person's name and contact information. By listing that person name, you agree that you have spoken with this individual for this task

How did you hear about Angels with Me? Are you willing to volunteer or fostering a dog/cat?

What is the name of the pet that you are interested for adoption, if known?

By submitting this form I accept all the terms and conditions of Angels With Me, a nonprofit corporation and acknowledge that there is no partial or total refunds in association with fees/expenses that I may incur in adopting a pet from this organization.

By entering my name I declared that I have read, understand and agree to abide by the condictions of the AWM Adoption Agreement Guidelines. I/We understand that all work done with AWM is at my/our own risk and fully irrevocable and unconditionally release and agree to hold harmelss Angels With Me (AWM) Rescue and its individual members from any and all know or unknown, anticipated or unticipated, suspected or unsuspected and/or fixed conditional or contigent actions, causes of actions, charges, suits, debts, demands,claims, contracts, covenants, liens, rights, liabilities, losses, royalties, costs, expenses (including without limitation, attorney's fees) or damages, including but not limited to any medical costs, damages to property, persons or other pets of every kind, nature and description, at law or in equity, in connections with or arising from while I/we are in the proccess of adopting or finalizing an adoption with Angels With Me.