Agree to prepay for the spay/neuter of the animal.
Be at least 18 years of age and have proof of residence.
Be willing to spend an average of two hours in the adoption process in
     exchange for a lifetime of love and friendship from the pet you adopt.
Have consent for adoption from all adults living in your house.
Understand that WRVC has the right to accept or deny your application and
     will follow up on adoptions.
Understand that your new dog or cat and all pets in your household must be
     properly vaccinated and licensed with the proper authorities.
Understand that all current pets (dogs/cats) in your household must be
     spayed/neutered, BEFORE bringing your new pet home.
Realize that although we will give your Pet Owner's Profile full consideration
     we do not approve adoptions on a first-come-first serve basis.  Adoption
     approval is based on the animal's best interest. 
Understand there is a waiting period of approximately 36 to 48 hours between
     the time a pet adoption application is approved and time the pet may
     be picked up.
------------------------------------------------------------------------------------------------

ANIMAL YOU WISH TO ADOPT

Today's Date               Adopter's Name

Cat         Dog                     Cat/Dog's Name

-----------------------------------------------------------------------------------------------
TELL US ABOUT YOU!

Last Name First Name Middle Initial

Spouse's First, Middle & Last names / Other Adult living in Household
 

Birthdate     Social Security Number

Current Address (Not a P.O. Box)  

City   State    Zip Code 

Home Phone   Work Phone 

How long have you been at this present address? 

Previous Address, if less than 2 year

City   State    Zip Code 

Employer   Position held

How Long with your Employer?   Supervisor

Please list types of pets you now own or have owned in the past:

Name	Breed	Kept Where	Age	Altered	Sex	Still own
				No Yes	select Male female	No Yes
				No Yes	select Male female	No Yes
				No Yes	select Male female	No Yes
				No Yes	select Male female	No Yes
				No Yes	select Male female	No Yes

If you no longer have the above pet(s), explain what happened to it (them) and when it happened.

Have you ever applied to adopt a pet before?  Yes   No
When? From Where

Number of adults in your household? 
Number of Children and ages

Please tell us why you would like to adopt an animal.  Check all that apply:
Gift    Companion   Breeding   Hunting    Mouser  For a child
Protection    Watchdog    Companion for another pet
Other

Would you object to a representative of WRVC coming to your home to check on the animal's well being?  No  Yes  If Yes, why?

If you rent, provide landlord's name
Landlord's phone number

Please provide three non-related references (must be 18 years or older)
 

Name	Daytime Phone