Responsible Pet Care Adoption Application-Internet Download

Please PRINT clearly

Name Birth Date:
Mailing Address
Street Address Town State Zip Code
Home Phone Cell Phone
How long have you lived at this address? Circle One: Rent or Own?
If renting, we need a signed and dated statement from landlord stating that pets are allowed, and any restrictions.
Landlord's name, address and phone number.
Your Occupation Work Place
Number of People in household Number of Children & ages
Reason for adopting a pet? Circle One:   Companion      Hunting     Rodent Control     Gift     Other (explain)
Does anyone in you home have allergies?      Yes      No          How many hours will pet be left alone in a day?
Have you ever been visited by the Humane Society or Animal Services? If Yes, explain on the back.
Have you ever brought an animal to a shelter? If Yes, explain on the back.
Do you plan to move in the next year?   If yes, what will you do with your pet?
Who will care for your pet if you go away?
What pets have you owned in the last 5 years that you no longer have and why do you no longer have them?
Have you previously adopted from RPC?    Approximate date:.
How will you control your pet while outdoors?
How many hours will the pet spend alone each day?    Where will it be kept while alone?
Are you prepared to pay for medical treatments that may arise?
Will you make every attempt to correct behavior issues that may occur with this pet?
Will you give this pet(s) all the love, care, and attention they deserve?
Do you have pets now?     Yes      No     If yes, list all dogs and cats in the home. Continue on the back, if necessary
Type(Dog or Cat)    Name     Spayed/Neutered?AgeSexRabies, Distemper,
Heart Worm Test Dates
All pets must be current on rabies and distemper vaccinations. Please attach your most recent vaccination records from your veterinarian or clinic, OR provide name and phone number so we may verify with your vet.
Your Veterinarian's name and location Phone No.
Please list two NON-FAMILY references and phone numbers. We will make calls between 9 a.m. to 4 p.m.
1. Phone No.
2. Phone No.

Please read and sign below

A cat/dog can live as long as 20 years. To provide care for that length is time is a commitment

Responsible pet owners provide their pets with yearly exams, vaccinations, keep their pets free of intestinal parasites and protected from heartworm and Lyme disease. Pet care is expensive. Cats can cost up to $400 per year for care and dogs up to $600 per year.

Pets need to be a part of the family. They require proper nutrition and water. They also require love, time and attention for their lifetime. Your new friend should not be left tied in the back yard. If left tied for extended periods of time severe behavior issues will occur. Pets should not be left in a fenced area unattended or allowed to roam free. They need to be kept safe inside or properly controlled outside.

Dogs need to be closely supervised when babies and small children are present. They should not be put in a position where they might cause harm; such as a child disturbing a sleeping dog or getting too close when the pet is eating.

Puppies and kittens require extra patience and training.

Many times there is no way to determine the behavior of your new friend. Be prepared for this and provide the attention and training necessary. Training your new pet will take extra time, but the long-term rewards of the time spent doing this will mean years of easier care and more enjoyment.

All pets need to be identified in case they are lost or separated if there is a disaster. Identification should be a collar with ID tag AND a micro chip or tattoo.

Contact Responsible Pet Care with any concerns at any time during the life of your new pet.

I, the undersigned, have read and truthfully answered all the questions. I understand that Responsible Pet Care (RPC) has the full authority to approve or deny my application. I realize that any false information could result in the forfeiture of this animal. I understand that the adoption fees are non-refundable. I understand that RPC cannot guarantee the health or temperament of any animal.

Signed: _______________________________________________________________ Date:______________________

Please call the shelter (207)743-8679 to let us know you are submitting an application.

Application approval takes between 24-48 hours depending on how soon your references and veterinarian can be reached. You will be notified by phone.

Mail to: Responsible Pet Care of Oxford Hills, 9 Swallow Rd, South Paris, ME 04281

FAX to: 207 743-3970

For administrative use

Approved_____    Denied_____    Verified Vet _____    Landlord_____    References_____    Other_____

RPC Adoption Counselor:                Comments:

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