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About Crowder College

Pet Adoption Application

Pet Adoption Program

For which pet are you applying?*
Personal Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Cell Phone*
Work Phone
Email*
Employer Information
Name of Employer*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Spouse/Partner/Roommate Information
Spouse/Partner/Roommate Name
First Last
Work Phone
Cell Phone
Pet living conditions information
What are the reasons for adopting a pet?*
Where will your new pet spend most of it's time?*
- Yard
- House
- Basement
- Kennel
- Other Area
Other area description*
What percent of time will your new pet spend in the Yard?*
Please enter a number from 0 to 100.
What percent of time will your new pet spend in the House?*
Please enter a number from 0 to 100.
What percent of time will your new pet spend in the Basement?*
Please enter a number from 0 to 100.
What percent of time will your new pet spend in a Kennel?*
Please enter a number from 0 to 100.
What percent of time will your new pet spend in Other area?*
Please enter a number from 0 to 100.
Do you have a fenced yard?*
- Yes
- No
Do you plan to chain or tie this pet in the yard?*
- Yes
- No
Will you have a pet door?*
- Yes
- No
Where will the pet be kept while you are at work or away from home?*
Where will the pet sleep at night?*
Discipline and Characteristics
How do you deal with house breaking issues?*
How will you deal with behavioral issues?*
What qualities are you looking for in a pet that you would like to adopt? Be very specific so we can make the best possible match? (couch potato, very active, etc)*
What do you expect to be the hardest part about adopting a animal, and how do you plan to address it?*
Current Pets
Do you currently have pets?*
- Yes
- No
What type of pets do you have
- Dog
- Cat
- Other
What other pets do you have?*
Who is your regular veterinarian?*
What were the dates of your current pets vaccinations?*
Are your current pets spayed or neutered?*
- Yes
- No
Are your current dogs tested for heart worm disease and placed on prevention?*
- Yes
- No
What specific heart worm prevention products is your dog on?*
Are your current cats tested for Feline Leukemia?*
- Yes
- No
I confirm that all the information in this application is correct and complete to the best of my knowledge and understanding. Information will be weighed and the best match for the animals will be considered and placed in the most appropriate home.
To sign form type in your name.*
Date

601 Laclede, Neosho MO 64850
417-451-3223

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