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Adoption Application

(Please Print Clearly)

Please provide complete and accurate information. Time
necessary to verify information will differ from case to case.
Multiple applications for the same animal will be evaluated
on a first come- first serve basis.
**Filling out application or “being first” applicant does not
guarantee approval for adoption.*
Applicant Information
Name:

License#

D.O.B

Address:

City:

State/Zip:

Employer:

Email:

Home#:

Cell#:

Residence Information
Do you: Own / Rent / Live with family who owns home?
(Please Circle One)
Length of residency:

Will you be moving:

Yard: yes/no

Fencing? Please Describe:

Will Your Homeowner or
renter insurance cover the
type of animal you are
applying for? Yes/no

If you rent or live with family please fill out this
section. (Home Owners please skip)
Landlord Name:

Landlord Phone:

Are pets
allowed? Y/N

Will it be okay if we contact your Landlord?
Yes/No

House Hold Information
Names and ages of adults living at residence:

Names and ages of minors living at residence:

Names and ages of minors that regularly visit:

Is anyone living in home allergic to animals? Yes/No
How will symptoms be managed?

Who will be the primary caretaker?

General Information
Where is your city/towns municipal shelter?

Have you ever been cited for a leash law or license violation?
Yes/no If yes, explain:
Are you aware for your town/cities ordinances regarding dog
licensing?
Are you aware of the leash law in you town or city?

If you travel, where would the pet stay?

If you moved, what would you do with the pet?

Have you ever given away or surrendered a pet?

Are you aware that the animal you are adopting may need basic
training? Are you willing to take time and work with the animal?
Have you considered the extra expenses that may come with
adopting your new dog/cat? This will include regular vet visits,
food, supplies, training, boarding, grooming etc. Annual cost can
range between $500-$1000 and or more per animal.

Current/Previous pet Information
How many dogs do you own? Males______ Females______
Spay/Neuter? Y/N

Vaccinated:

Y/N

How many Cats do you own? Males______ Females______
Are the Spay/Neutered?
Felv/Fiv Positive?

Y/N

Vaccinated?

Y/N

Y/N

Have you had pets before? Y/N
What happened to them?
What is your current veterinarian?
Phone#:

DOG Applicants
Dogs Name:

Sex:

Pet will be: indoor,

On a regular basis how long will

indoor/outdoor, outdoor (Please

the dog be left alone?

circle one)
Where will the dog be kept when it is alone?

How will the dog be exercised?

What veterinarian or veterinarian clinic will you use?

CAT Applicants
Cats Name:

Sex:

The cat will be: Indoor, Indoor/outdoor, outdoor (Please circle
one)
Do you plan to declaw the cat? Y/N
What veterinarian or veterinary clinic will you use?

I declare that I have answered the above questions truthfully and hereby give
the Woonsocket Animal Shelter permission to verify with my landlord or
veterinarian. I also give the permission for the volunteers or workers to call me
or the attending veterinarian of my adopted animal after the adoption to
ascertain the well being of the animal I adopt.
**********
I understand that the dog/cat I wish to adopt cannot leave the facility until
either spayed/neutered, stated under the RI General Law 4-19-16
“4-19-16 Mandatory spayed and neutering of
Dogs and cats adopted from a licensed
Releasing agency.”

Signature: __________________________________ Date: _______________