ADOPTION APPLICATION | Melissa's Second Chances

PERSONAL INFORMATION

We'd love to get to know you a little better!

Hi! What's your name? *

First

Last

Date of Birth *

You must be at least 18 years old to adopt from Melissa's Second Chances.

Drivers or Government Issued ID Number *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Additional Phone *

Email *

Current Employer *

Have you previously adopted an animal from Second Chances? *

Yes
No

Do you still have the pet?

Yes
No

HOW CAN WE HELP?

Sorry, we just adopted out the last unicorn... Lots of other great creatures to fill your life with joy, though!

What type of animal are you looking to adopt? *

Are you applying to adopt a specific animal? *

No
Yes
Yes, but also open to good fit suggestions

Which animal are you interested in?

Would you prefer a male or female animal? *

Male
Female
Either

Animal Age Preference *

What is the oldest animal you would consider adopting? *

Do you have any preferred traits of an animal you adopt? (good with kids, compatible with current pets, house trained, etc.) *

Are there any behaviors that would be unacceptable? *

LIVING SITUATION

Let's try to make sure your new furry family member will be a good fit in their forever home!

Do you rent or own your primary residence? *

Rent
Own

Landlord's Name *

Landlord's Phone Number *

Does your landlord allow the type of pet you are interested in? *

Yes
No
I don't know

Does your landlord require a pet deposit for the type of animal you are interested in? *

Yes
No
I don't know

Does your landlord have a size/weight limit for the type of animal you are interested in? (copy) *

Yes
No
I don't know

What is the size/weight limit? *

Please list the names and ages of all human members of your household *

Please list all animals currently in your household and animals you have had in the past 5 years (Name, Species, Breed, Spayed/Neutered, Age, What happened if you don’t have them anymore) *

Will the animal you are interested in primarily live indoors or outdoors? *

Where will this animal be kept while you are at work, school, etc? *

Do you have a fenced/fully-enclosed yard? *

Yes
No

How tall in the lowest part of the fence/enclosure?

What would you do if your pet is destructive while they are alone? *

How do you plan to train and discipline an animal you adopt? *

Under what circumstance would you feel justified in getting rid of a pet? *

LOOSE ENDS

Almost done, we promise!

Please list three personal references with their phone numbers *

What is the name of the veterinary clinic you typically use? *

What is the veterinary clinic's phone number? *

By clicking the submit button, I understand Melissa’s Second Chances will check my references including Veterinary and personal.

By clicking the submit button, I verify all of the above information is true and accurate.