Please know that each animal taken into the BAAC receives their initial vaccinations, de-wormings, are microchipped and are spayed/neutered before adoption. Date Name Email Street City State Zip Location/Nearest Crossroads Home Phone Work Phone Are you a member of the National Humane Education Society? YesNo How did you become aware of us? How long have you lived at the above address? Please indicate the type of dwelling that you live in? HouseTownhouseApartment/CondoMobile HomeOther If you live in an Apartment, on what floor do you live? Do you have a yard? YesNo Size of yard? Is your yard fenced? YesNo Type/height? Do you own or rent your home? OwnRent If you are renting, does your lease allow pets? YesNoN/A How many adults are in your household? How many children are in your household? Ages? Is there anyone home during the day? YesNo Hours at home: Is this your first experience with a pet? YesNo Do you currently own other pets? YesNo If yes, are they up to date with their vaccination boosters? YesNo Currently Owned Pets Pet Name Species Breed Gender Altered Age Healthy DogCatOther MaleFemale YesNo YesNo DogCatOther MaleFemale YesNo YesNo DogCatOther MaleFemale YesNo YesNo DogCatOther MaleFemale YesNo YesNo DogCatOther MaleFemale YesNo YesNo Do you have any declawed cats? YesNo Do you have dogs with cropped ears or docked tails? YesNo What are you interested in adopting? PuppyDogKittenCat Any specific breed or mix? What age range? Under 1yrUnder 2 yrs2-5yrs5yrs or older What size? Under 15 lbsUnder 30 lbsUnder 50 lbs Other preferences(i.e., calm, active, type of coat): If you have any specific animal(s) in mind, please list name(s): Please list your reason(s) for wanting to adopt an animal: Where will this pet be primarily living? InsideOutside Where will your pet sleep at night? Type of exercise are you planning to provide a dog? How often do you plan on exercising your dog? Previously Owned Pets In addition to your current pets, please list any other animals that you have owned in the past five years and what happened to them: Pet Name Species Breed Gender Altered Age What Happened? When? DogCatOther MaleFemale YesNo DogCatOther MaleFemale YesNo DogCatOther MaleFemale YesNo DogCatOther MaleFemale YesNo DogCatOther MaleFemale YesNo References Who is your veterinarian? Veterinarian's Phone: Please provide your landlord's Name: Landlord's Phone: (Please note: We require confirmation of approval from your landlord before showing animals) Other References: If you adopt an animal from the BAAC, will you agree to the following: Agree to provide proper food, fresh water, weatherproof, clean shelter and humane treatment to the animal Agree to keep my pet on my property or within my control at all times Keep the adopted pet current on all health check-ups & vaccinations Purchase a properly fitted collar and license (if required) for your specific area Agree not to tie or chain the pet as a primary means of confinement Give a reasonable amount of time to allow the pet to adjust to your home I Agree Did you have a specific amount of time in mind for adjustment? Do you have any other questions or concerns? For what reasons do you feel you might need to return an animal? Submit
