Adoption Application

Thank you for your interest in our rescue animals. In order to be considered for an adoption from Jethro's Place, you must:

1. Be at least 21 years old with valid ID containing current address.
2. Live within 75 miles of Detroit.
3. Be able to pay an adoption fee of $100 for adult cats and $225 for dogs .
4. Have consent of adoption from all adults living in the household.

Animal Information

Animal's Name:      Date:   
Description (breed, color, etc.):

Adopter Information

First Name:   Last Name:
Spouse/Partner's First Name:   Spouse/Partner's Last Name:
Address:   City:   State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY   Zip:
Major Cross Streets:
Phone Number:   Cell Phone Number:
Email Address (REQUIRED):

Please double check that you have entered the correct email address! Please check your email frequently, as we will communicate with you via email initially, and it is important that we are able to reach you.

Employer:
City:   State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Phone:

Emergency Contact Information (other than spouse/partner):
Name:
Phone:

Are you over 21 years of age? Yes   No

How many adults (other than yourself) are living in your household (please give ages)?

 

How many children are living in your household (please give ages)?

 

If you don't currently have children, are you planning on having children in the future? Yes   No   Maybe

Are you on public assistance? YesNo

Are other members of your household in agreement with the adoption?YesNoNot sureHaven't discussed it

Have you ever adopted an animal from a rescue league, humane society or animal shelter before?YesNo
If "Yes," which one(s)?
Approximate date(s):

What is the reason for adopting this animal? (Check all that apply.)
Animal lover
Companionship
Teach my children responsibility
Favorite breed
Want to breed
Functional duty
Felt sorry that animal was a victim of abuse/neglect
Couldn't resist, the animal is so cute
Gift for someone    Gift for whom?
 

How did you hear about Jethro's Place? (Check all that apply.)
DRQ, 93.1 (radio)
MetroTimes
Petfinder.org
PETsMART
Fox's Good Day Live/Best Friends Animal Sanctuary
Other (please explain)    
 

Can you afford regular veterinary care for the new pet? YesNo

Do you agree to have annual checkups and all vaccinations administered by a licensed veterinarian? YesNo

Who is your regular/previous veterinarian, or what vet will you be using?
Clinic:
Vet: City:   State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Phone:

How many pets do you currently own? --no selection-- 0 1 2 3 4 5 6 7 or more
 

Please list:

Have they all been spayed/neutered?YesNo
Are they all current on vaccinations? YesNo

Have you owned this type of animal (dog, cat, etc.) before? YesNo

If you have owned ANY type of animal before, what happened to it? Still haveDied Other:
If the animal(s) died, by what cause?

If you have an animal in your residence now, have you ever introduced it to a new animal?YesNoDon't have other animals
If "Yes," how did your pet react? FavorablyDifficult AdjustmentIndifferent

Please provide the names, species, gender, ages and vets of all pets that have lived in your home in the past 5 years.
 

Will anyone be home during the day for the new animal? YesNoSometimes

If NO, how long will the animal be left alone, and where will the animal stay while alone?

Where will the new animal be housed? HouseYardBoth
If you answered "Yard" or "Both," what type of shelter will be provided for the animal?
BarnShedDog KennelOther (please describe)

Where will the new animal sleep?

Is your yard completely fenced in? YesNo

If YES, what type of fence? ChainlinkWoodOther

If YES, how high is the fence? feet

Do you rent or own your current residence? RentOwn
What type?HouseMobile HomeApartmentCondominium
If RENTING: Landlord's Name:  Phone:
Will the landlord allow pets? YesNo
If YES, are there any restrictions?
Pet Deposit (in U.S. dollars): $

If you are interested in adopting a cat or kitten, do you intend to declaw? YesNo Maybe

If you are interested in adopting a cat or kitten, do you plan on letting him or her outdoors? YesNo Maybe

Do you plan on doing obedience training with your new animal? YesNo Maybe

What are your feelings about crating the animal?

 

How will you handle the adjustment period of the new animal to your home?

What methods will you use to deter destructive behavior (e.g., inappropriate
chewing, going to the bathroom in the house, etc.)?

If you move in the future, what will you do with the animal?

How often and what type of exercise do you plan on giving the animal?

Please provide the names and phone numbers of three personal references. Please include one neighbor, if possible. Please do NOT include family members/relatives:

Name:   Phone:

Name:   Phone:

Name:   Phone:

Thanks for taking the time to fill out the application.

Is there anything else you would like us to know as we review your application?

I understand I am to notify Jethro's Place Animal Sanctuary immediately if the situation should arise in which I am no longer able to keep the adopted animal or if it appears the animal is sick or has been lost or stolen.
Applicant's Initials:

Jethro's Place Animal Sanctuary

Have you reviewed our adoption procedures? If not, please do so now. Don't worry--it'll open in another window so you won't lose the information you just entered!