Alna Animal Shelter by dux15396

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									                                        Alna Animal Shelter
                                             21 Ames Road
                                      Alna, Me 04535
                             207-882-7421 or Fax 207-882-6760
                                        Date______________
                         DEPOSIT CONTRACT on Purchase of Animal
              Cat Kitten Bird Shelter Animal ID #            __________      of Animal
                   Puppy D.O.B.     /    /      Adult Dogs Age or D.O.B.          /    /
    Is the animal here with in N/S Yes No if No will you agree to have N/S Yes or No
    There will be a deposit for the insurance that you will follow through, having N/S By said
date      /    /       for your refund to be issued back to you, fax or send via snail mail us a
              copy of the certificate to receive such refund of     $_______________
               Coat Color Blk /Wht           Red /Wht      Gry/Wht       Other _____
     Animals [Right eye color     Blue Brown      ]   [Left eye   Blue   Brown]       Male Female
                           Does animal have special needs: Yes No
                   Tattoo Number________ or Microchip number _____________
                    Pure breed Yes No           AKC Registered animal Yes No
$ _______ Adoption Price Of Animal
$ _______ Neuter / Spay Deposit will be refunded when a copy of certificate is faxed or
mailed we then will issue a check this is to be done by_________ or no refund will be given
unless said by the veterinarian that it should not of been done for reason must be in writing
to us by the attending veterinarian.
$    40.00    Microchip with pre paid registration
_________ Subtotal
_________ - Less Deposit
_________      Balance due at time of pick up


**Final payment must be made either by cash money order **
Personal checks will be accepted as final payment, but only after the check has cleared will
you be able to pick up your Adopted animal. Thank you for your understanding in this
matter. I have read or have had read to me the above contract and the health guarantee
and I understand and agree to the terms of both of these documents.
Adoptee Signature_______________________________________
Print Name_________________________ S.S. Number For your personal
Address________________________________________________
Phone# ________________________________________________
Signature of Shelter _________________________________________________
Print Name__________________________________________________________
                                       Alna Animal Shelter
                                            21 Ames Road
                                     Alna, Me 04535
                            207-882-7421 or Fax 207-882-6760


             Cat Kitten Bird Shelter Animal ID #             __________     of Animal
                  Puppy D.O.B.     /    /      Adult Dogs Age or D.O.B.         /    /
Is the animal here with in N/S Yes No if No will you agree to have N/S Yes or No
  There will be a deposit for the insurance that you will follow through, having N/S By said
date     /    /       for your refund to be issued back to you, fax or send via snail mail us a
             copy of the certificate to receive such refund of    $_______________
              Coat Color Blk /Wht           Red /Wht        Gry/Wht    Other _____
   Animals [Right eye color      Blue Brown     ]   [Left eye   Blue   Brown]       Male Female
                            Does animal have special needs: Yes No
                  Tattoo Number________ or Microchip number _____________
                   Pure breed Yes No           AKC Registered animal Yes No
               Questionnaire                   Age Group 20 30 40 50 60 other
When some one wants an Animal from us we require you to answer the complete packet we
  care where are animals go please answer all questions So we can determine if you would
    make a suitable pet owner for said animal, also determine if this Pet is right for you!
Buyers Name ______________________________________ Sex M F
Mailing Address___________________________ City /Town
____________State____ Zip ________
Physical Residence if not same as mailing address________________________
State____ Zip ______                                Email
Address_______________________________________ Tel
Number______________________
Circle and or fill in spaces below please
Are you married Yes No
Are you Employed Yes or No
Where Please give your Place of employment
Company Name
__________________________________Address_________________________
_____        Telephone number______________ ext.______ how long employed
____________can we call there to verify Yes No if no why not __________then
please show recent pay stub for verification wages, or salary aprox.
______________
                                    Alna Animal Shelter
                                        21 Ames Road
                                    Alna, Me 04535
                           207-882-7421 or Fax 207-882-6760


Will your spouse financially provide for this purchased animal? Yes No


Spouses Name __________________________________
Do you Own or Rent        where you are living ? If you Rent you will need to fill out a
Landlord Permission form stating you can have pets where you are renting or leasing See
form with in the adoption packet
How many years have you lived here at address above?                 Years    Months             Is
this animal going to reside at address above Yes No if No where
________________________________________


What will and can you provide for this Animal while it lives with you?
Taking in a Animal is a life time commitment so are you and your family prepared
for the whatever?     Yes or No


Are you willing to do what it takes to care for such a pet provided there could be life altering
situation(s)


Such as: We have to move (Get rid of pet) oh we don't have time anymore or the dog is
jumping on the kids oh he’s nipping or biting at them. oh he has been so sick and we cant
afford to pay medical bill so let put him down or got hit by a car and no money is worth
spending on for his injuries. We are all faced with everyday challenges in our lives and its
your responsibility to do what it takes to care for a pet and not just pass the responsibility
on to someone else like putting the animal back into a animal shelter or having the animal
euthanized So will and can you give to a animal what it takes Yes No
                                  Alna Animal Shelter
                                     21 Ames Road
                                  Alna, Me 04535
                         207-882-7421 or Fax 207-882-6760




Please give us things you will or can do for this animal that you want to bring into
your home


Will this animal be in a pen outdoors? Yes    No
Is Pen up already? Yes No
On a Run or stake outdoors? Yes No
In the House Yes No     Other_________
Will you use a crate for this animal you are adopting Yes   No
if Yes When__________ How long will it be left in crate _______________
Do you have knowledge of crate training Yes        No
How many hours will the animal be left alone ___________
Say you discover that your pet has anxiety issues will you seek Doggie Daycare In
the home or away from Yes No or take pet to work with you provided you have the
type of job that allows you this freedom Yes No
Will you take pet to obedience’s school    Yes No
Would you have a animal euthanized Yes or No


Please give comments you would like to add here in the best interest of the animal
you want to adopt
                                Alna Animal Shelter
                                  21 Ames Road
                                Alna, Me 04535
                       207-882-7421 or Fax 207-882-6760



                              INCOME VERIFICATION
Persons Name providing for this animal
financially_____________________________________ if other then buyers name
above_________________________
Is this animal going to be residing with someone different then the Adoptee Yes No
if yes give persons person s name ____________________ address
_________________________ Tele_______________ Relationship to
buyer____________________
Please circle which apply         Is this animal a gift         Surprise
Other Explain why are you choosing this breed of animal for your pet?
__________________________________________________________________
__________________________________________________________________
__________
What do you know about this breed you want adopt________________________
Do you have other animals Yes No? ______________________ if yes please list
them ___________ ____________ _________ do you think your new pet will get
along with the animals you now have? Yes No not sure
What will you do to see that they do get along if they seem to not be getting along
with each other
_________________________________________________________________


Number of children that you have and their ages _______________ or that will be
around the animal and their age’s ______________or that will be living with this
animal, please give the ages of the children __________________ Will the
children help with this animal? Yes No


All of the questions you have answered on this form must be true if found out that
they were answered false then animal may be subject to be asked that you must
return
                                  Approval status
Landlord check Ok Yes No / Veterinarian Approved Yes No / Employment approved
                                         Yes No
                                         Alna Animal Shelter
                                              21 Ames Road
                                      Alna, Me 04535
                             207-882-7421 or Fax 207-882-6760
                           ADOPTION AGREEMENT OF SAID ANIMAL
              Cat Kitten Bird Shelter Animal ID #             __________      of Animal
                    Puppy D.O.B.     /    /      Adult Dogs Age or D.O.B.          /    /
Is the animal here with in N/S Yes No if No will you agree to have N/S Yes or No
 There will be a deposit for the insurance that you will follow through, having N/S By said
date     /      /       for your refund to be issued back to you, fax or send via snail mail us a
              copy of the certificate to receive such refund of      $_______________
                Coat Color Blk /Wht           Red /Wht      Gry/Wht       Other _____
   Animals [Right eye color        Blue Brown      ]   [Left eye   Blue   Brown]       Male Female
                            Does animal have special needs: Yes No
                    Tattoo Number________ or Microchip number _____________
Pure breed Yes No            AKC Registered animal Yes No


  We at Alna Animal Shelter have the right to examine and make inquiry about the said
  animal in this contract at any time, and if we find that the animal is not in good living
  conditions and or in good health, and not up to date as far as the vaccinations as to the
 standards of the State of Maine Animal Welfare, we may demand the animal to be turned
                                      over to us upon demand.
             What I will agree to as the Adoptee of said animal in this contract
       I agree to provide proper water and adequate food, and kind treatment at all times,
        meeting with the approval of Alna Animal Shelter.
       If for any reason I do not any longer desire to keep the said, animal in this contract I
        will not sell, give away, or abandon for any reason. I must inform Alna Animal
        Shelter before doing any of the above and return it to Alna Animal Shelter.
       I will take said animal to a licensed veterinarian for a health check with in 24 hours of
        my adoption. I will continue a full veterinarian program to prevent and or cure
        illness.
       I will obey local laws regarding, licensing and all animal control laws .
       I agree and understand that this animal should be vaccinated against rabies
   Feline’s 3-5months of age for canines 4- 6 Months of age
   For other animal see what is appropriate for the species_________
       I agree to have this animal neutered or spayed by a licensed veterinarian of my
        choice, no longer then 6mths of age or as agreed upon with in this contract
                                   Alna Animal Shelter
                                      21 Ames Road
                                  Alna, Me 04535
                         207-882-7421 or Fax 207-882-6760


     Your Adoption price of said animal is only refundable if said animal is not in good
      health stated from licensed veterinarian with in 24 hours of the day you adopted it
      from the animal shelter You must have warranty validated at this time, if not
      validated from licensed veterinarian then this warranty is Null and void from further
      action being taken toward the animal shelter.
     Alna Animal Shelter is in no way responsible for any damages in which your purchased
      animal may do to another person’s property, and no attempt will be made to hold the
      Alna Animal Shelter responsible.
I ______________________________ Understand that this agreement is a legal and
binding Contract between Alna Animal Shelter. And myself the Adoptee.
Adoptee's Signature ________________________________________ Date               /          /
                                       Alna Animal Shelter
                                         21 Ames Road
                                      Alna, Me 04535
                             207-882-7421 or Fax 207-882-6760


               VETERINARIAN RELEASE OF PET OWNERS INFORMATION
     I ____________________________________ am Giving Alna Animal Shelter
       Potential Animal Adoptee's Signature
       The right to contact my Veterinarian for medical information on my prior
       pets medical care we have or given to our pet (s) seen by veterinarian listed
       here Name of Pet _________________ Type of Pet               Cat     Dog Other
       Name of Pet _____________________ Type of Pet                Cat     Dog Other
       Name of Pet _____________________ Type of Pet                Cat     Dog Other
       Name of Pet _____________________ Type of Pet                Cat     Dog Other


Name of Hospital or Clinic your previous or past pets have / or are still being seen
by
_________________________________________________________________


Address__________________________________________
Tel__________________
Veterinarian’s Name if known _____________________________________


       To whom it concerns: Could you release in writing any and all pet care
       information pertaining to this Potential animal adoptee on the pets they have
       listed or pets in their file.
                        You may Mail or Fax back to us see heading above
       This person (s) wants to purchase / adopt ___________________________
       (Type of Animal wanting to adopt)


       It is required we have documentation from adoptee's veterinarian before any animal
       may be considered adopted here from our facility.


       1. Has this person within this release form properly caring for pets animals listed
       with in your clinic
       2. Is the pet(s) up to date on vaccination Rabies     Yes   No   Annual Boosters per
       species Yes No          Lymes Yes No      HTW    Yes No      Other
       as well as given the medical attention to all animal (s) in your file or other animal
       (s) that you knew they owned Yes        No   Explain______________________
                                   Alna Animal Shelter
                                      21 Ames Road
                                   Alna, Me 04535
                         207-882-7421 or Fax 207-882-6760
3. Would you care to add comments to this person(s) creditability to owning and caring for
animals of any kind? We hope you do so below, it is for the best interest of the animal being
adopted that we have asked you to answer this question.
_________________________________________________________________________
_____________________________________________________________________


   X_________________________________________________________ Date                   /    /
     Veterinarian Signature or Office Secretary Signature authorized to complete this form


Feel free to contact us for any or all questions you may have concerning this
matter and ask for Helen Webber


Thank you for taking the time in answering the questions and added information
you have given us. It is helpful in our determining the placement of animals that
want to be adopted from our facility.
                                     Alna Animal Shelter
                                          21 Ames Road
                                   Alna, Me 04535
                          207-882-7421 or Fax 207-882-6760


                        LANDLORD RELEASE OF INFORMATION
                     Let me introduce myself, we are an Animal Shelter
    We like to have the approval of landlords allowing the renter have animals within its
        building or single home that you rent to this person we are inquiring about.
  Before we release animals to the potential purchaser or adoptee we must have your ok.
                        See below what the renter wants to adopt .
                   Animal ID #       __________      of Animal Male Female


               Puppy D.O.B.      /    /     Adult Dogs Age or D.O.B.     /     /
                        Does animal have special needs: Yes No
               Tattoo Number________ or Microchip number _____________
   I ______________________________________ Give Alna Animal Shelter.
            Potential Animal Buyer’s Signature
the right to contact my Landlord for information on weather or not I can have
animals with in this building I rent
Name of Landlord__________________ Address_______________________
Telephone ___________
      To whom it concerns: Could you release in writing any and all information
      pertaining to this Potential animal adoptee on are they allowed to have animals or
      pets with in the building you own and rent to them.
                      You may Mail or Fax back to us see heading above
      We must have your information before any animal leaves our facility in case this
      person should not have any other or more pets, simply due to not properly caring for
      the animal (s) they have or have owned in the past or still own.
      1. Has this person within this release form properly keep its animal (s) on your
           property safe, clean or looked after that you are aware Yes   No.
      2. Does this person pay its rental fee on time Yes    No
      3. How long has this person rented from you?       Months ______ Years       _______
      4. How many animals have you known this person to have _______ or had _______
           or that they still own_______________ can you tell us what they
           are._____________
      5.   What size lot or yard does this Renter have access to?
           _______________________
                                   Alna Animal Shelter
                                      21 Ames Road
                                       Alna, Me 04535
                           207-882-7421 or Fax 207-882-6760
       6. Is this building or single home on busy road that might not be considered safe for
          animals if they were to get loose or escape Yes    No is there a fenced in area
          available or is the renter able to put one up if they do decide to have a animal
          such as a dog   Yes or No
Would you care to add comments to this person(s) creditability to owning and caring for
animals of any kind? We hope you do so below, it is for the best interest of other animals
that we ask you to answer this question.
_________________________________________________________________________
X____________________________________________________________________
            Landlords or Office Secretary Signature authorized to complete this form
     Feel free to contact us on any or all questions you may have concerning this mater
 Thank you for taking the time in answering the questions and added information you have
given us. It is helpful in our determining the placement of animals Adopted from our facility.

								
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