Welcome to Horse Creek Wildlife Sanctuary and Animal Refuge. Thank you for your interest in adopting a pet.

The following information is requested so that we can assist you in the selection of your new pet. THE ANIMAL'S WELFARE IS OUR FOREMOST CONSIDERATION. Our process is designed to help us determine if adoption is in the animal's best interest and to assist you in finding an animal most compatible with your lifestyle.

The animals available for adoption came here from a variety of sources. All animals are examined upon entry and animals of appropriate age are spayed/neutered. Their health is routinely monitored, but there is always a chance that an animal is incubating a disease without showing any clinical signs.

Horse Creek reserves the right to refuse adoption to anyone. No animal will be adopted to persons having an extensive history of losing, giving away, or selling animals, or of having animals injured or killed by moving vehicles. No animal will be adopted to prospective owners who mislead or fail to provide accurate information on the adoption application.

IN ORDER TO BE CONSIDERED AS AN ADOPTER, YOU MUST:

* Be 18 years of age or older.

* Have identification showing your present address.

* Have the knowledge and consent of your landlord.

* Be able and willing to spend the time and money necessary to provide food, shelter, medical treatment, appropriate training and proper care for a pet.

You may print and fax this form to (731) 926-3000 or copy, paste and email it to admin@horsecreekwildlife.org.

APPLICANT INFORMATION:

Name: _________________________________________________________________

Spouse Name: ________________________________________ Date: _____________

Address: _______________________________________________________________

City: ___________________________________ State: _____ Zip: ________________

Home Phone: ________________________ Work Phone: _______________________

Email Address: _________________________________________________________

Employer: _____________________________________________________________

ADOPTION INFORMATION:

What kind of pet would you like to adopt? ___________ Adult Dog/Puppy

Why do you want a pet? __________________________________________________

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Do you have any preferences as to breed, sex, age, size, length of hair, etc.?

________ Yes/No

If yes, what are your preferences? _________________________________________

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Is this your first experience with a pet? _______ Yes/No

What pets do you currently have in your household?

Name	Type	Spayed/Neutered?	Kept Where?	Age
______________	______ Dog/Cat	______ Yes/No	______ In/Out	______
______________	______ Dog/Cat	______ Yes/No	______ In/Out	______
______________	______ Dog/Cat	______ Yes/No	______ In/Out	______
______________	______ Dog/Cat	______ Yes/No	______ In/Out	______
______________	______ Dog/Cat	______ Yes/No	______ In/Out	______

List pets owned in the past five years other than those listed above.

Type	Spayed/Neutered?	Kept Where?	What happened to the pet?
_____ Dog/Cat	_____Yes/No	_____In/Out	________________________________
_____ Dog/Cat	_____Yes/No	_____In/Out	________________________________
_____ Dog/Cat	_____Yes/No	_____In/Out	________________________________
_____ Dog/Cat	_____Yes/No	_____In/Out	________________________________
_____ Dog/Cat	_____Yes/No	_____In/Out	________________________________

Who is your veterinarian? _________________________________________________

Where do you currently live? _________________ House/Apartment/Condo/Duplex/Mobile Home

Do you own or rent? ______________ Own/Rent

If you rent, does your lease allow pets? ___________ Yes/No

If you rent, what is your landlord's name? ______________________________________________

What is your Landlord's Phone Number? ______________________________________________

How long have you lived at your current address? _______________________________________

How many people live in your household? _____________________________________________

Do all the adults know that you plan to adopt a pet? ____________ Yes/No

If there are children in your household, what are their ages? ______________________________

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Does anyone living in your household have any known allergies to animals? ______Yes/No

If yes, to what kind(s) of animals? ___________________________________________________

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Who will be responsible for the care of your pet? ______________________________________

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Where will the pet be kept during the day? ___________________________________________

Where will the pet be kept at night? _________________________________________________

How many hours a day will the pet spend without human companionship? __________________

Where will the pet be kept when alone? ______________________________________________

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Are you willing to have a Horse Creek representative visit the pet's home? ________ Yes /No

Why do you want a dog? (Check all that apply.)

____House Pet ____Guard Dog ____Watch Dog ____Companion ____Gift ______Company for Other Pet

____ Other: ____________________________________________________________________

Do you have a fenced yard? ______ Yes/No If yes, how high is the fence? _________________

How will you keep your dog confined to your property? (Check all that apply.)

____ In House ____ Kennel ____ Fenced Yard ____ Patio ____ On Chain ____ Garage ____On Leash

Do you realize you may have to housetrain your new puppy or dog? ______Yes/No

What will you do if your dog chews furniture or shows other destructive behavior?

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Will you take your dog to obedience training classes? _______ Yes/No

List two people who would recommend to us that you adopt one of our dogs. (List names, addresses & phone numbers.)

Name: _______________________ Address: __________________________________ Phone: ___________________

Name: _______________________ Address: __________________________________ Phone: ___________________

How did you hear about Horse Creek Wildlife Sanctuary and Animal Refuge?

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ANY COMMENTS OR SUGGESTIONS?

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