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Adoption Application
Personal Information
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
Preferred Method of Contact
*
Phone
Email
Address
*
Line 1
Line 2
City
State
Zip Code
Country
PLEASE NOTE: The Green Ark adopts to residents of New England only. We do not adopt internationally, including Canada.
Pet Information
Please tell us a little about the type of pet that you are interested in adopting.
Is there a specific pet you are interested in adopting?
*
I am interested in adopting (check all that apply):
*
Adult Dog
Puppy Under 6 Months of Age
Activity levels (check all that apply):
*
Couch Potato
Ready for an adventure, but also a nap
Energetic & active, let's go!
Size (check all that apply):
*
Small (under 25 lbs)
Medium (25 lbs - 59 lbs)
Large (60 lbs - 95 lbs)
Extra Large (95+ lbs)
Please detail any restrictions you may have (i.e. allergies, cats, small children, rented property that doesn't allow bully breeds, etc.)
*
History & Home
Please tell us a little about your home, pets, and family.
Do you have any pets today?
*
Yes
No
Current Veterinarian
*
Vet's Phone Number
*
Pet Name(s)
*
Does your pet receive preventatives?
*
Heartworm Preventative
Flea & Tick Preventative
Note
:
We
will
reach out to your veterinarian to ensure your current pets are up-to-date on Rabies and Distemper vaccinations, fixed, and in general good health. Please call your veterinarian and authorize them to release information to The Green Ark upon request.
What best describes your living situation?
*
I own my home
I rent a home or apartment
I do not rent or own my own place
If a renter, Current Landlord
*
Landlord's Phone Number
*
Do you have landlord permission to have pets in your home?
*
Yes
No
Note
: We
will
reach out to your landlord to ensure pets are allowed in your rented property. Please check your rental agreement to ensure there are no size or breed restrictions.
Have you or any member of your household been convicted of animal cruelty, including abuse or neglect?
*
Yes
No
Personal Reference
Please provide a personal reference. The ideal personal reference can speak to your history with animals and reinforce that you will be a responsible and caring pet owner. This person should not be immediate family (no parents or spouses, please).
Personal Reference
*
First
Last
Phone Number
*
Closing
Anything else you'd like us to know?
*
Submit
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