Online Adoption Form

Please take a moment to read our Adoption Requirements. If you are ready to provide a loving home to one of our wonderful pets, complete this form in its entirety and send it to us by clicking the "send" button at the end. PLEASE BE SURE TO INCLUDE YOUR EMAIL ADDRESS! If you have any trouble submitting the form, or receive any kind of error message, please notify us by email and proceed to the printable adoption form. Thank you!

PERSONAL INFORMATION

Name:         Spouse:    
Address:   
City:          State:       Zip Code: 
Home Ph:  Work Ph:  Cell Ph:    
Email:      
TX Driver's License #:  
Name, age & relationships of other family members living in your home:
Employer: How Long?:
Address:
City:           State:        Zip Code:     
Own or Rent home?      Own Rent Fenced Yard?       Yes No
Name of Manager/Landlord:    Phone: 
Do you have permission from the Manager/Landlord to have pets?         Yes No
Please fax written permission from your landlord/manager to 409-948-3311.
Name of nearest relative not residing with you:
How is he/she related?:
Address: 
City:            State:    Zip Code: 
Home Phone: Work Phone:     Cell Phone:      
How did you hear about our organization?
Which of our pets are you interested in?    
Are you financially capable of taking care of an ill or injured pet? (This can cost hundreds of dollars)
Yes No
Where will you keep your pet?    
Veterinarian's Name: Phone:
Are you or anyone in your household allergic to cats or dogs? Yes No
How many hours a day will the pet be alone?
If you leave town, who will care for your pets?
Who will take care of your animal if something happens to you?
What will you do with your pet if you move?
How long do you intend to keep your pet?
Describe the type and number of animals you currently have at home.
Have all dogs in your home been tested for heartworm? Yes No Not Applicable
Have all cats in your home been tested for FeLV and FIV? Yes No Not Applicable
Have your dogs consistently been on heartworm preventative without a break in protection? Yes No Not Applicable
Have they had veterinary checkups/shots within the past year? Yes No
If not, please explain:
Have they been Neutered/Spayed? Yes No
If not, please explain:
What other animals have you had and what happened to them?

Please read our adoption requirements and application very carefully. In the event you are approved, the contract you will sign is a legal and binding document.

Your signature below is your promise to adhere to our requirements and to provide for the medical, emotional, and physical needs of the adopted pet for the rest of its natural life in the event you adopt from us.


Signature of Adopter Date Signature of Adopter Date


Approved By:_____________________________________________________
Whiskerville Representative