North Fork Animal Welfare League - Adoption Application

North Fork Animal Welfare League, Inc.
PO Box 297
Southold, NY 11971

631.765.1811

Adoption Application

NAME:
PHONE #:

STREET ADDRESS:

MAILING ADDRESS:

SPOUSE’S NAME:

NUMBER OF CHILDREN:
AGES OF CHILDREN:

ROOMMATE’S NAME:

DO YOU LIVE IN A HOUSE OR IN AN APARTMENT?
OWN OR RENT?

LANDLORD’S NAME:
LANDLORD’S PHONE#:

OCCUPATION (SELF):
EMPLOYER’S NAME:
PHONE #:
OCCUPATION (SPOUSE):
EMPLOYER’S NAME:
PHONE #:

Which pet(s) are you interested in adopting?

Have you adopted from N.F.A.W.L. before?

If yes, when? Breed of pet: Name of pet: Do you still have this pet?

Have you ever adopted from another shelter before? If yes, which shelter?

When? Breed of pet: Name of pet: Do you still have this pet?

Do you currently have any pets? If yes, please describe:

Are they spayed or neutered?

Is their veterinary care up to date?

If you have no pet now, did you have pets before? If yes, where are they now?

Do you or anyone in your household have any allergy to pets?

Where will you keep your new pet?

How many hours a day will your pet be left alone?

Where will your pet be kept during that time?

How will you provide for your pet’s exercise and elimination needs?

What will you do with your pet if you move or your situation changes?

Do you agree to accept FULL financial responsibility for all veterinary care for your pet’s lifetime?

Do you agree to have your pet spayed or neutered?

Do you agree to treat your pet with love, patience and respect and abide by all animal welfare laws?

If your pet is a cat, do you agree not to have your cat declawed?

If your pet is a cat, do you agree to take your cat away from the shelter in a pet carrier?

Do you agree to let a NFAWL representative visit your pet in its new home?

Are you a member of NFAWL? Would you like to become one?

REFERENCES:

Veterinarian’s Name: Phone #:

Name #1: Relationship: Phone #:

Name #2: Relationship: Phone #:

Name #3: Relationship: Phone #:

Applicant’s Signature:
Date:

North Fork Animal Welfare League is a non-profit animal welfare organization which operates the Southold Animal Shelter. The League provides dogs and cats with food, shelter, medical care (vaccinations, de-worming, heartworm tests, Feline Leukemia Virus and Feline Immunodeficiency Virus and other preventative and curative treatments, as necessary), spaying or neutering, as applicable, etc. (and love!). NFAWL is under Town Contract to provide Dog Control Services for the Town of Southold. Dog adoption and license fees are payable to The Town of Southold. New York State does not license cats. NFAWL rescues and cares for cats through the support of voluntary donations. Adoption fees are set at a minimum level to accomodate adoptions by persons of limited means. We request that if it is not a hardship you make an extra contribution at the time of adoption payable to NFAWL so that we may continue our work with the homeless cats and dogs of Southold Town and provide them with the care they deserve.

In order to help us serve our community better, please tell us how you heard about the Southold Animal Shelter:

FOR OFFICE USE ONLY

PET SHOWN BY:
DATE:

COMMENTS:

APPLICATION PROCESSED BY:
DATE:

APPLICATION APPROVED [ ] APPLICATION DENIED [ ]

If denied, please state reason(s):

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Southold Animal Shelter
North Fork Animal Welfare League
adopt1@softhome.net
631-765-1811