Name
*
First Name
Last Name
Address
Please note: potential adopters should live within 1 hour from Henrico, VA
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Email Address
*
Employer
*
How long at job?
*
Is there a Co-Applicant?
*
Yes
No
If Co-Applicant, please provide additional info.
Co-Applicant Name, Address, Phone Number, Email, Employer, and How long at job?
Is there a specific animal you are interested in?
*
Yes
No
If Yes, please provide name.
If you are interested in a specific animal, are you open to any other animal?
Yes
No
What physical traits are you interested in? (Select all that apply.)
*
Kitten (< 1 yr)
Cat (1-6 yrs)
Senior (7+ yrs)
Male
Female
Will this pet be declawed?
*
Yes
No
Where will this cat be kept?
*
Indoor only
Outdoor only
Indoor/outdoor
Barn cat
What are you looking for in a cat? (Select all that apply.)
*
Declawed
Shorthair
Longhair
Lap Cat
Energetic
Good w/ Kids
Good w/Dogs
Good w/Cats
Companion
Special Needs
Bonded Pair
Playmate for other pet
What behaviors would you find unacceptable, and how would you handle them?
Why is this a good time for you to adopt a pet?
*
Please tell us about your lifestyle and the type of pet you think would be the perfect match for you and your family.
*
Who will be the primary caretaker of the pet?
*
What would happen to your pet if you had to move?
*
If something were to happen to you, who would take care of your pet(s)?
*
How much money are you prepared to spend for the care of your pet each year?
*
Please provide the number of adults in your household & their ages.
*
Please provide the number of children in your household & their ages.
*
Are all of the adults in the home aware of, and agreeable to, adopting a pet?
*
Yes
No
Do you own or rent?
*
Own
Rent
If you rent, please provide your landlord's name and number.
How long have you been at your current residence?
*
< 1 yr
1-4 yrs
5+ yrs
Who do you live with? (Select all that apply.)
*
Live alone
Spouse
Significant Other
Children
Roommate
Parents
Other
Does anyone in your home have asthma or pet allergies?
*
Yes
No
Who will take care of your pet when you go away overnight?
*
Where will your pet stay when left alone at home?
*
Where will your pet sleep at night?
*
How many hours per day will your pet be alone?
*
<2 hrs
3-6 hrs
7-9 hrs
10+ hrs
How do you plan to exercise your pet?
In the past 7 years, have you had pet(s) that are no longer with you?
*
Yes
No
If Yes, please provide additional information.
Kind of pet & what happened to them.
Have you previously adopted a pet through a humane society or animal shelter?
*
Yes
No
If Yes, please provide the name of the society/shelter and the type of pet(s).
Have you ever returned/surrendered a pet to a humane society or animal shelter?
*
Yes
No
If Yes, please provide the name of the society/shelter, the type of pet(s), and the reason for surrender.
Have you ever been reported to animal control or had an animal removed from your care?
*
Yes
No
If Yes, when did this happen, and please explain the circumstances & outcome.
Do you have other pets now?
*
Yes
No
If Yes, please provide additional info about your current pet(s).
For each pet, please provide: type, name, age, sex, spayed/neutered (Y/N), Date of last shots, how long you've had the pet, where the pet stays (inside/outside/both)
Do you have other pets in your home that belong to someone else (relative, roommate, etc)?
*
Yes
No
If Yes, please provide additional info about the pet(s).
For each pet, please provide: type, name, age, sex, spayed/neutered (Y/N), Date of last shots, how long you've lived with the pet, where the pet stays (inside/outside/both)
Current Vet: Name & Number
Previous Vet: Name & Number
Please list three people outside of your home as references.
*
Include name, phone number, and relationship.
Today's Date
*
MM
DD
YYYY
How did you find out about this adoption opportunity?
Facebook
Instagram
Henrico Humane website
3rd party adoption site (Petfinder, Petango, Adopt-a-Pet, etc.)
Friend or family member
Adoption event (Petco)
Other
I live within 1 hour driving distance from Petco Short Pump (11331 W Broad St, Glen Allen, VA 23060)
*
Please validate that you live within 1 hour from Petco Short Pump. We only adopt to people within this radius.
Yes
No