Your Full Name (required)

Your Email Address (required)

Home Phone (required)

Work Phone

Mobile Phone (required)

Fax Number

Street Address (required)

City, State, ZIP Code (required)

Your Date of Birth (required)

Why do you want a pet?

Pets you are interested in: (required)

How did you hear about us?

Type of pet you would like:

DogCat

Gender

MaleFemale

Where will you keep the pet?

What will you do with your pet when nobody is home?

What will you do with you pet if you travel out of town?

What will happen to your pet if you move?

Have you ever owned a pet?

YesNo

If so, how long did you own the pet, and what happened to it?

Do you currently have pets? (required)

YesNo

If so, please tell us about them, including age, disposition, gender, and if your pets are spayed or neutered?

Please tell us how many people are in your household, and list their ages (required)

Is anyone in your household opposed to a new pet?

YesNo

Do you own or rent your home? (required)

OwnRent

If you are renting, please provide your landlord's name and telephone number.

Is your yard securely fenced?

YesNo

If so, what kind of fence do you have?

Do you have a swimming pool?

YesNo

How will you ensure your pet's safety outdoors?

What will you do if your pet has behavior problems, such as not being housebroken or chewing?

How much time would you be willing to give a new pet to get used to you and the new surroundings?

What medical care will you provide for your pet, and how often?

How much do you feel your pet's medical care would cost?

What will you do if your pet becomes ill or injured and requires expensive medical care?

What will you do if your pet becomes lost?

Please provide the name and number of your current or past veterianarians,even if they are in another city or state:

If your vet records are listed under another name, please provide us with that name, and let us know why the name is different?

Does your current veterinarian give your pet annual shots?

YesNo

If not, please let us know who gives your pets shots.

Where do you purchase flea & heartworm prevention? (If purchased online, we must have an account number.) Proof of heartworm prevention must be provided to be considered for an adoption.

Please provide us with names and phone numbers of at least 3 references. Please not that only one of these references can be a family member.

Please read this before submitting your application.

By signing this application, the applicant agrees to allow Guardian Angel Pet Rescue to check the references provided.
The applicant must also agree if they are granted a pet and for whatever reason cannot keep it, they MUST return the pet to Guardian Angel Pet Rescue. The adoption donation is NON REFUNDABLE. Guardian Angel Pet Rescue of Memphis is 100% committed making each placement as perfect as possible. Our goal is to make both the approved applicant and the pet lifelong friends.

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