TEJAS RESCUED PET ADOPTIONS
ADOPTION APPLICATION
Address:
City, State: / Zip:
Home phone:
Home e-mail: / Work e-mail:
Cell phone: / Occupation:
1. What type of pet are you interested in?
Dog Puppy (under 6 months) Cat Kitten (under 5 months) Adult Long Hair Short Hair
Name of pet you are interested in:
2. How many people currently reside in your household?
3. Any children in the household? Yes No List ages:
4. For whom are you adopting the pet? Self Gift
5. Does any member of the family have any allergies to animals? Yes No
If yes, explain:
6. Who will be responsible for the pet’s care?
7. Where do you live? Apartment Condo Farm Mobile home Townhouse House
8. Are companion animals allowed? Yes No Not sure
9. Where will the pet be kept? Indoors only Outdoors only Both in/out
10. If outdoors, will the pet be attended unattended collar & tags?
11. Will anyone be home during the day? Yes No Not Monday-Friday 8-5
12. How many hours will the pet be left unattended?
13. When no one is home, where will the pet be kept?
14. If you move, what will you do with the pet?
16. Describe your current companion animals?
17. Are your companion animals current on their vaccinations? Yes No
18. Please provide name and phone number of your veterinarian:
19. Can we contact your vet for a reference? Yes No
20. Are you planning to declaw this pet if it is a cat? Yes No Not sure
21. Have you ever adopted an animal from a rescue/animal control agency? Yes No
22. Do you agree to permit a visit to your home/farm by appointment? Yes No
By signing this form, I/we acknowledge that all information on this form is true and correct. I/we understand
that any misrepresentation of fact may result in Tejas Rescued Pet Adoptions refusing adoption privileges to me/us. If
my/our request for adoption is approved and later Tejas Rescued Pet Adoptions discovers the above information is
not true or correct, I/we give TRPA at , the right to remove the adopted pet from my home/farm.
Signature ______Date ______
TEJAS RESCUED PET ADOPTIONS
ADOPTION CONTRACT
I, as the adopter of this pet agree to the following terms and conditions.
If I do not comply with these terms, Tejas Rescued Pet Adoptions may reclaim the pet.
- I am adopting this pet to be a member of my family to live in a private residence.
- I will provide nutritious food, water, and personal attention for the life of this pet.
- I will never strike or otherwise harm this pet.
- I will ensure pet’s vaccinations are current and will provide immediate veterinary care for sickness, disease, or injury.
- I will supervise introduction of this pet to all other pets and children.
- I WILL NEVER ABANDON OR DISPOSE OF THIS PET. If I can no longer care for or keep this pet, I will find a loving home for it. If unable to find such a home, I will return the pet to Tejas Rescued Pet Adoptions.
- I understand that if I let my pet out, it will be only in a safe environment with supervision. I will not allow this pet to run loose, unsupervised.
- If this pet is a cat, I agree not to declaw this cat unless behavior modification efforts have failed. Declawing will only be used as a last resort. I understand that a declawed cat cannot survive outside and will keep pet inside at all times.
- I will not hold Tejas Rescued Pet Adoptions responsible for any present or future illness of this pet or for any damage, it may do to any person or property.
- I will give Tejas Rescued Pet Adoptions visitation rights to ensure that the terms of this adoption agreement are being observed.
- I understand that failure to perform the foregoing agreement will constitute a breach of contract. In this event, the pet can be reclaimed.
In return for the above conditions, Tejas Rescued Pet Adoptions agrees to allow the prospective caregiver to adopt the
above-mentioned pet. This agreement was executed atCity ______State ______
Adopter Name: / Adopter Address:City, State: / Zip:
Home phone: / Work phone:
Home e-mail: / Work e-mail:
Veterinarian:
Regarding the pet described as follows:
Name of pet: / Tracking/med record #
Age: / Sex:
Breed: / Description:
Rabies Tag #: / Adoption Donation: $
Adopter: / Tejas Rescued Pet Adoptions Counselor:
SIGNATURE ______/ SIGNATURE ______
DATE ______/ DATE ______
Tejas Rescued Pet Adoptions
P.O. Box 790372 . San Antonio, TX 78279-0372 . 210 416-3947