Please fill out the following application completely and accurately. We will get back
to you as soon as possible. Thank you!

IMPORTANT!! Please indicate any pets you are interested in by entering their
names below. We will do our best to match you up with the pet of your choice.
However, please be aware we cannot guarantee availability.


Pets:
First Name:
Last Name:
Email:
Date:
Address:
City:
State:
Zip:
Phone(home):
Phone(work):
Texas Driver's License Number:
Employer:
Ages of children living in your home:
What type of dwelling do you live in? (Ex. House, Apartment, Condo)
Do you own or rent?
Landlord's Name:
Phone:
Do you have a fenced area(yes/no)?
Do you have a kennel(yes/no)?
In not, do you plan to comply with the leash law?(yes/no)
Are you planning to move within the next six months?(yes/no)
If you do, what will you do with the animal?
Does anyone in your family have allergies to animals?(yes/no)
How long will you give for your new pet to adjust to your family?
Did you discuss adopting a pet with all family members?(yes/no)
Why do you want to adopt a pet? Guard, Watch, Companion, Breeding, Gift,
Other.(choose one)
Where will your pet live and sleep?
Please elaborate.
Are there any activies you will share with your pet?
How will you discipline your pet?
Bored, restless, lonely dogs often vent their frustration by chewing, digging,
and barking.
How would you deal with these issues?
What steps will you take to control fleas?
How will you transport the pet?
Are able and willing to pay for shots, heart worm medication, food,
equipment, toys, flea control, and vet care?(yes/no)
How many hours a day will the animal be left alone?
Do you know how to house train the pet?(yes/no)
What brand of heartworm medicine does your pet use?
Temperament wanted? (choose one) Active, Quiet, Protective, Gentle,
Other.
List any other pets you have including name, breed, age and sex.
Can you keep pets separated if necessary?(yes/no)
Please Explain
List previous pets and what happened to them.

Who is your veterinarian?
Vet's phone?
How will you exercise your pet>(yes/no)
Have you applied to adopt an animal from us before?(yes/no)
If you could no longer keep the animal what would you do with it?

Have you ever surrendered an animal to a shelter?(yes/no)
If yes, what were the circumstances?
Enter any further comments below:

By pressing the submit button you are confirming the following.
I certify all the information in this application is true and I understand
that false information may void the application. I also understand that
failure to comply with the adoption requirements could result in my inability
to adopt other animals from the SPCA of Montgomery County. I further certify
that I give my Veterinarian my specific authorization to release information
to the SPCA of Montgomery County on the care and services provided to me for
my current or previous pets.