Adoption Application

The drop down menus work, they will record your choices but the line may remain blank in your view.

Name: *
Address: *
Age *
Email Address: *
Phone Number: *
Type of Domicile: *
Do you Own or Rent? Please choose from menu. *
If you rent, please provide landlord's phone number:
How many people live at this address? *
Are there children at this home?
Ages of other adults in the home:
If there are children at this home, what are there ages?
What kind of animal are you looking for? *
Are you interested in a specific NWAC rescue animal? If so, who?
Please Describe the pets living in your home now their ages and activity level:
Please tell us about your previous pets (species, breed, spayed/neutered and where they sleep):
Are there any special requirements you have regarding the new animal? (e.g. age, sex, size, maintenance needs) *
Please provide your veterinarians name and number:
Who will care for an animal while you are not at home?
Do you prefer or plan for your pet to be: *
What life changes in the next 10 to 20 years will impact your pet?
Have you ever had to find a new home for one of your own pets before? If so please describe the reason.
Please offer any additional information you feel would be helpful regarding yourself/family:
Do you have any questions or comments?

Please answer these questions if you are adopting a dog:

Do you have secure fencing for your dog?
Please describe you yard, if it is fenced and the height of the fence:
If you do not have secure fencing, how will you contain your pet?
Where will your dog sleep when you are home and when you are not at home?
On average how many hours will your dog be left alone during the day?
How will you socialize your pet?
How will you train your pet?

Please answer these questions if you are adopting a cat:

Have your other pets ever lived with another cat before? Did your pets get along with and like the cat?
If you adopt a cat, are you intending to declaw? *
If yes to declaw please indicate the age you plan schedule the operation: