Adoption Application

First Name

Last Name

Address (including City, State and Zip Code)

Phone

Employer's Name

Employer's Address

Co-Applicant Name

Co-Applicant Email

Co-Applicant Employer

How long at current residence and if renting/leasing please list Landlords Name and phone number.

List other animals in household. Include Type and Age.

Are all current pets up to date on vaccines and spayed/neutered?

Current Veterinarian's name and phone #

List your previously owed pets (Last 10 years)

Have you ever surrendered, sold, given away, or euthanized one of your pets? (if yes, please explain)

Name of pet your are applying for.

Are you looking for a kitten, cat or dog?

Have you adopted from us before? If yes, when

Thank you for interest in Adirondack Save A Stray. Your application will be reviewed and you should receive a follow up phone call or email within 24 hours.