North Country Society for the Prevention of Cruelty to Animals

Adoption Application

* Animal you are applying for:

* Petfinder ID#:

General Information

* Name

Partner/Spouse's Name

Address	City	State	Zip
Mail Address	City	State	Zip

Home Phone

Work Phone

* Email Address

Is your partner/spouse aware that you are adopting an animal?
Do you or your partner/spouse have children?

If yes, please list the ages of the children

Residence Information

Do you rent or own?

Do you live in an apartment, house, or mobile home?

Landlord's Name

Landlord's Phone

Is there a yard available to you at your home?

How do you plan to confine the animal to your yard?

On average, how many hours will the animal be left alone per day?

Where will it be during this time?

Companion Animal History

Do you own other pets?	If yes, please list other pets
Are they spayed or neutered?	Have you ever had the type of pet you are applying for?
If yes, how long did you have that animal?	What happened to that animal?

Your Responsibility to Your Pets

Are you prepared to make a 10-20 year commitment to this animal?

What kinds of behavior do you feel unable to accept of this animal?

A new pet requires time to adjust to a new environment. Will you allow at least 2 weeks for this adjustment period?
*NOTE: If an animal is returned to the North Country SPCA prior to the 2-week period, no money will be refunded unless agreed to by the shelter manager prior to adoption.

Are you aware that the cost of vet care for a pet can be anywhere from $150 to $300 annually?

Are you financially able to care for this pet?
*NOTE: This includes the cost of feeding a well-balanced diet, providing routine veterinary care - vaccinations, physicals, heartworm test and prevention, and intestinal parasite testing - as well as providing any emergency medical care.

If your pet has not been spayed or neutered at the shelter, do you agree to spay or neuter it within the period required by New York State Law?
*NOTE: The law requires that every animal adopted from a shelter must be spayed or neutered prior to adoption, within 30 days of adoption (if 4 months or older), or within 30 days of your kitten or puppy becoming 4 months of age.

Who is your veterinarian?

Phone

Have you ever surrendered an animal?

If yes, what was your reason and where is the animal now?

Employment Information

Are you working full-time, part-time, unemployed, retired, attending school, homemaker, or other?
Employer's Name	Phone

Please list two references (not relatives):

Name	Phone
Name	Phone

North Country SPCA

North Country Society for the Prevention of Cruelty to Animals, Essex County, New York

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