Your Name

Email Address

Pet You Are Applying For

Phone Number

Full Address

Date of Birth

Occupation

Please give us the name and phone number of the last Veterinarian you used for your current/past pets:

Are you Adopting this Pet for Yourself? Are you Adopting this Pet for Yourself? Yes No

How many people live in your household?

How old is each child in your household?

How many pets currently live in your household?

Have the children had any experience with pets? Explain:

Do you rent or own your home? Do you rent or own your home? Rent Own

Do you live in a: Do you live in a: House Apartment Condo/Townhome Mobile Home

If renting, does your landlord allow pets? If renting, does your landlord allow pets? Yes No

Do you have a fenced yard? Do you have a fenced yard? Yes No

If your yard is fenced, please list the type and height of the fencing.

Do you have a swimming pool? Do you have a swimming pool? Yes No

If you have a pool, is it in ground or above ground?

If you have an in ground pool, is it fenced?

How many hours will your pet be home alone daily?

Where will your pet stay when you are not home? Where will your pet stay when you are not home? Fenced Yard (not chained) Fenced Yard (chained) Run House (unconfined) House (confined) Garage Unfenced Yard Crate Other

What flea control treatments do you use?

What heartworm prevention do you use?

Have you and your dog ever participated in an obedience class?

Have you had experience in housetraining?

Are your current dog's or cat's vaccines up to date?

Have your cats been declawed?

List the number and type of pets you currently own:

Were your current/past pets spayed or neutered? Were your current/past pets spayed or neutered? Yes No

Have you ever adopted from a shelter or rescue group? Have you ever adopted from a shelter or rescue group? Yes No

Why do you want a pet?

Who will be the primary caregiver for this pet?

List 2 personal references (not related to you) along with their contact information:

Please include a brief history of your past pet ownership (if any)

Do you agree to the Adoption Guidelines outlined on the Love to Live website? Do you agree to the Adoption Guidelines outlined on the Love to Live website? Yes No

Do you acknowledge that by clicking SUBMIT you are stating that all of the information given in this application is true and accurate to the best of your knowledge. Do you acknowledge that by clicking SUBMIT you are stating that all of the information given in this application is true and accurate to the best of your knowledge. Yes No