Adoption Application Adoption Application Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell Phone*Work PhoneEmail* Employment Status*Full TimePart TimeStudentUnemployedOccupation*Do you rent your home?*YesNoLandlord Name (if renting)Landlord Contact Number (if renting)How long have you lived at your current address?*Have you adopted from us before?YesNoHow long have you thought about getting a companion animal?*What type of companion animal are you interested in adopting?*CatDogOtherWhat age companion animal are you interested in adopting?* Baby Young Adult Senior Would you consider a special needs companion animal?*YesNoMaybeWhy are you interested in adopting a companion animal?* Companion for self Companion for children Companion for other animal Guarding/Protection Hunting/Herding Mouser If there is a specific companion animal in our program that you are interested in, please enter the name here.Please list all members of your household:*NameRelationshipAge Do all household members agree to adopt?*YesNoDoes any member of your family or regular weekend visitor have allergies to companion animals?*YesNoWho will be primarily responsible for the care and supervision of the companion animal?*Where will the companion animal stay?*Inside OnlyOutside OnlyInside/OutsideWhere will the companion animal be kept during your vacations or absences from home?*Select the reasons that would make you return or give away a companion animal.* Moving Allergies New roommates New pet New baby The companion animal has fleas or sheds fur Getting married or divorced The companion animal destroys household items Behavioral problems Children will not take care of the companion animal Children lost interest Moving to an apartment or residence that does not permit companion animal Not using the litter box Too time consuming Shedding Chewing Scratching None of the above Check all that applyWell-cared-for companion animals may live in excess of 15 years. Does your lifestyle, career & family plans allow you to make this kind of commitment?*YesNoIf your companion should develop special needs in the future, what level of care and attention is your household comfortable taking on?* Pilling daily Daily eye drops Special dietary food Litter box use problems Shyness Heart problems Diabetes or other complex care None check all that applyYour new pet will cost a minimum of $400 per year for veterinary care, food and expenses. This does not include cost of any injuries or emergencies.Who will assume financial responsibility for this animal?*Your companion animal may develop minor to major health problems throughout its life. What is a comfortable annual dollar amount for your household to spend on Vet bills?*$200$500$1000Whatever it takesWhat would you do if your current or future rental or apartment did not allow pets?*If you have to move from your current residence, what provisions will you make for your cat or dog?*Take with meDepends on whether place accepts animalsGive to relative or friendPut animal in safe place during moveReturn to TAASHow will you discipline or your cat or dog?*Do you plan to have your cat declawed?*YesNoI'm not getting a catPlease list past (last 5 years) and current companion animals below:Companion animal's nameCat or Dog?Spayed/Neutered (yes/no)Indoor, outdoor, or both?Shots current? (yes/no)On heartworm prevention? (yes/no)Age of companion animalWhere are they now?Living or deceased (pick one) When and in what way will your companion be allowed outdoors? (check all that apply)* Never On a leash On a deck or patio Out during day / In at night On a screened porch When companion wants to go out When I am at home Under my supervision In a fenced yard Where will your cat/dog sleep at night*Veterinarian NameClinic/Practice NameVeterinarian Phone*Do you want to be contacted by email about future events?*YesNoAs part of the adoption process, a TAAS volunteer will call your veterinarian for a reference, or your personal reference if you do not currently have a veterinarian. If applicable, we will also confirm with your landlord that you are allowed to have pets in your home. By clicking the box below, you agree to these provisions:Reference checkbox* Click here to confirm I have read this application and provided accurate information to the best of my knowledge. Any misrepresentation of facts may result in the adopted animal being removed from the home. Click the box below to confirm.Signature checkbox* Click here to confirm Please allow a 48 to 72 hour processing time for each application. If you apply on a weekend, expect the longer period. A TAAS volunteer will, however, be in touch with you during that time. Because the welfare of our foster animals is very important, TAAS reserves the right to decline any potential applicants.