Brooks SPCA Adopt A Pet by lonyoo


									Brooks Animal Protection Society Box 86, Brooks, Alberta, T1R 1B2 Phone: (403) 362-4323 Fax: (403) 362-8316 Animal Control: (403) 793-7840 Email: Website:

Breed: __________________DOB: _______________ Spayed / Neutered Vaccination Date: _________ Booster Date: ___________ Vet Apnt: _______________
Office use Payment $_______ cash / debit / cheque New Name:___________________

Dog Adoption Request
Pet Requesting: _________________________ Name: _____________________________ Address: ____________________________ __________________________________ Email:______________________________

Ph# Home:_______________________Work or cell:_____________________ How long have you lived at your current address: ____________________ Do you: Rent Own If you rent, are you allowed to have pets? Yes No Landlords name & phone #: ________________________________________ Do you have a fenced yard? ________ how tall is the fence? __________ Do you Plan to tie out your dog? _____________ How many times a day will you walk your dog? ________________ What type of activities are you interested in doing with this dog?____________________ Are you aware of its breeds tendencies and if it’s a puppy what size it will be? ________ Are you willing to take your dog to training classes if needed? _________________ You agree to never let the dog to ride exposed or unsecured in the back of a truck? _____ Please list other family members, including the ages of children: ________________________________________________________________________ Is everyone in the household aware of the adoption? Yes No

What pets do you currently have in your household and what are their ages? ________________________________________________________________________ Are they spayed or neutered? ________ How many pets have you owned? ___________

Have you ever had a pet destroyed due to behavioral problems? _______________ Have you ever surrendered a pet to a animal shelter? ____________________ Do you have a regular veterinarian, lease list name and number: __________________ Can we contact your veterinarian? ________________ How much do you anticipate to spend yearly on care for your pet? __________ If your pet needed emergency medical care how much are you willing to spend?_______ What will you do with your pet when you are on vacation? ___________________ What will you do with your pet if you move ? ____________________________ Under what circumstances would you return this animal? ______________________ Please give 3 references: _______________________________________________ ____________________________________________________________________ Would you be willing to allow a BAPS representative to visit your home? ___________ Special notes or conditions: _______________________________________________ _______________________________________________________________________

All the information I have given in this Adoption request is true and complete, I understand that any false information will cause this adoption to be automatically rejected. Should an animal be placed with me, it will reside in my home as a pet. I agree to provide the pet with adequate food, water shelter, affection and medical care. Brooks Animal Protection Society is in no w liable or responsible for any damage, accident or injury from the placement of a pet. If for some reason I am no longer able to care for or want the pet that is placed with me, Brooks Animal Protection Society will be contacted first to decide where the pet is to be placed. Except for the initial vaccination, altering, and deworming Brooks Animal Protection Society is not responsible for any veterinary costs incurred after the time of adoption, including costs for pre-existing problems. I have read, understand and agree to the above mentioned:______________________

Approved: _____________________

Date: __________________________

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