Fillable ADOPTION APPLICATION CITY OF TAYLOR ANIMAL SHELTER Does (City of Taylor)

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ADOPTION APPLICATION CITY OF TAYLOR ANIMAL SHELTER Does (City of Taylor)

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ADOPTION APPLICATION
CITY OF TAYLOR ANIMAL SHELTER
701 E. 4
TH
, TAYLOR, TEXAS 76574
512-352-5483
SANDY PERIO – ACO SUPERVISOR
Pet ownership is a serious commitment that the entire household needs to consider and agree to before the
animal is adopted. The City of Taylor Animal Shelter (COTAS) wants to ensure that each adoptive household
is aware of, and willing and able to accept, the physical and financial responsibilities of pet ownership. Not
everyone who desires to own a pet is ready to properly care for one. By completing this questionnaire, you will
aid us in determining if your household is prepared to assume the role of responsible caretaker for a rescued
animal. Thank you!
Does your entire household know that you are considering adopting a pet?
Yes No
If no, why not?
Do you feel that a pet should be spayed/neutered?
Yes No
If no, why not?
Household Member Information (Please Print)
Are you 21 years of age or older? Yes No Picture ID is required for adoption
Adopter’s Name:
Street Address:
City/State/Zip
Telephone Numbers
Main #: Alternate #:
Email:
Other Adult(s) at Residence:
Number of children living in the house: Ages: Live there full time? Yes No
Your Home
Do you live in a House Apartment Mobile Home Townhouse Other
Do you own your home?
Yes No
If you rent, you MUST provide proof of permission to have an animal on the premises.
Landlord Name: Landlord Phone:
Describe your yard:
Fenced Kennel Run No Fence
Does anyone in your household have allergies to animals? Yes No
If yes, to what kinds of animals?
Describe your home’s activity level:
Active Noisy Quiet Average
Approximately how many hours each day would the animal be left alone?
If the animal becomes ill or injured, are you financially prepared to provide the medical care? Yes No
Your Current Animals
Who is responsible for the daily care of the above listed animals?
Who is responsible for them when you are on vacation?
How many pets have your owned in the past?
Veterinarian Name: Phone:
What name is your vet record(s) listed under:
3-Day Visit:
□
Yes
□
No
Adopt Date:
Animal Name:
ACO DB #:
Animal Name __________________________
Last, First ______________________________
ADOPTION APPLICATION
CITY OF TAYLOR ANIMAL SHELTER
ACO DB # ___________
Please list all animals that you presently own (other than fish, rodents and reptiles) None
Type
(i.e., dog)
Breed
(e.g., Boxer, Persian)
Time
Owned Age Sex
Vaccinations
Current? Heartworm
Female
Male
Spayed
Neutered
Yes
No
Pos
Neg
Female
Male
Spayed
Neutered
Yes
No
Pos
Neg
Female
Male
Spayed
Neutered
Yes
No
Pos
Neg
Female
Male
Spayed
Neutered
Yes
No
Pos
Neg
If Heartworm positive, is the animal being treated? Yes No
Your New Dog
(N/A for cat adoption)
Why are you considering adopting a dog? Hunting Companionship Breeding Protection
Where would the dog be primarily housed? Inside Outside Equally Inside/Outside
Where would the dog stay when you are not home? Loose Inside Loose Outside
Crated or otherwise confined inside Kennel run/fenced area outside Tied/chained outside
Other (describe):
If fenced, what is the height and approximate size of the fenced in area?
Height: Size:
If fenced, are the gates always securely latched and/or locked? Yes No
If the dog is outside other than for supervised activities, describe what shelter would be available for it:
Doghouse Covered Area (e.g., Porch) Shade Trees Garage/Shed
Other (describe):
How do you plan to handle the dog’s exercise needs?
References (
Please list someone who is familiar with both you and your pets)
Name: Name:
Address: Address:
Phone: Phone:
Relationship:
Relationship:
Individuals who adopt a COTAS dog or cat are contacted periodically for an update to help ensure that the
animal successfully adjusts to its new life.
Do you consent to home visits, with notice, before and/or after the adoption? Yes No
Best time of day to call to check on how the adopted dog is adjusting? __________________
All the information I have provided in this application is true and correct. If any of the information changes, I will
advise COTAS promptly.
Adopter Signature:
Date:
COTAS Reviewer:
Date:
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ADOPTION APPLICATION CITY OF TAYLOR ANIMAL SHELTER Does (City of Taylor)

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Completed 16 July 2020

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