SPAY-LEE APPLICATION FORM

Note: All answers on this app MUST be completed. Otherwise, your application will not be processed.

Please copy and paste application into an e-mail, fill out your answers and e-mail responses back to apic@aol.com for the pet you are interested in.

We do not keep applications on file. Please watch www.spay-lee.com for updates.
___________________________________________
Date:
Name of pet you are interested in:
___________________________________________
Are you applying to another rescue in this state, if so, which?

Are you applying for another pet on the SPAY-LEE website? If so, which one/s?

___________________________________________
Name:
Street
City:
State:
Zip Code :
Home Phone: (_______ )
Cell Phone (______ )
How late can we call you?
What is your age range? 18-35_______ 36-50_______ 51-65_________66-75____________ over 75__________

Occupation :
Work Phone:

E-mail address :
___________________________________________
Do you own or rent your home?

Please provide directions from a major roadway:

____________________________________________
How long have you lived at this address?
If less than 2 years, what is your former address?

___________________________________________
If own, does your homeowner's insurance allow dogs?
Name of insurance Company and agent with phone #:

______________________________________________
If rent, will your landlord approve ownership of pet?
Landord's name and phone number:
Do you have an enclosed fenced yard?
If fenced, what type fencing?
How high?
If no fence, how will the dog be exercised and pottied?
How far from your front door is the road?
___________________________________________
Would you be willing to have a home visit before adopting a pet?

___________________________________________

In event of a hurricane or other disaster what plans are in place for you and your pets?

___________________________________________
Will the pet be exposed to children on a regular basis?
If yes please answer the following questions:
Age:
Sex :
Live with or how often visit:

Age:
Sex :
Live with or how often visit:

(If more, please answer above questions for each child.)
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How many adults other than the primary owner will live in the house with the pet?
How many children will live in the house?
___________________________________________
If you have life style changes such as:
New Baby
Moving
Divorce
Remarry
Other
What if anything do you plan for your pets?
___________________________________________
If you become ill or deceased, who will take care of the pet?

___________________________________________
Do you own other pets?
If yes, are they currently licensed in your county?
If yes, are they currently microchipped?
What type of Heartworm Preventative medication do you use?
What brand dog food does your pet eat?
How often is he/she fed?
How often is water available for your pet?
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For any dogs in your home, please answer the following:
Name:
Age:
Sex:
Neutered?
Breed:
How Obtained?

Age:
Sex:
Neutered?
Breed:
How Obtained?

(If more, please answer above questions for each dog.)
___________________________________________
Do you own any cats?
How many?
If yes, are they currently licensed in your county?
If yes, are they microchipped?
If yes, please answer the following for each cat:
Age:
Sex:
Neutered?
Indoor or Outdoor:

Age:
Sex:
Neutered?
Indoor or Outdoor:

Have your cats lived with dogs before?
___________________________________________
Describe any other animals that you own:

___________________________________________
Is there someone home during the day?
Is there someone home during the night?
Where will the pet stay during the day?
Where will the pet stay during the night?
Where will the pet sleep?
___________________________________________
Will you have a dog house for your dog?
If yes, where will this dog house be located - front or back yard?
What type/brand is the dog house?
Is dog house in a fenced-in yard or will you keep the dog on a chain near the dog house?
___________________________________________
What other pets have you owned in the past?

Please give each pet's name and breed, the length of time you had the pet,
and the reason why you no longer have the pet.

___________________________________________
Why would you like to own this breed/pet?
Have you ever obedience trained a dog before?
Would you be willing to take obedience lessons with your dog, if you are applying for a dog?
What would cause you to give up your pet?
___________________________________________
Your current or most recent Veterinarian:
Veterinarian's Address
Veterinarian's Phone number ( _____)
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LIST TWO PERSONAL REFERENCES
Name:
Relationship:
Phone: (____ )

Name:

Relationship:
Phone: (_____ )
___________________________________________
Have you ever been refused a pet adoption?
If yes, by whom?
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Have you ever had to give up a pet for any reason?
If yes, please state reason:
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For what reasons would you give up a pet?
----------------
Do you live in a county or city with pet limits?
If so, how many pets are you "permitted" to have?
___________________________________________
Are you aware once you adopt this pet, you cannot sell, give, or in any way transfer ownership of him/her? This pet MUST be returned to SPAY-LEE.
___________________________________________
Where did you hear about SPAY-LEE?
___________________________________________

Thank you. Someone will be getting back to you shortly.

If you do not hear from us in a week, however, please contact us.