Adoption Request Form





Name *




First



Last

Contact Number *



Email *



Address *




Street Address



Address Line 2



City



State / Province / Region



Postal / Zip Code



Country

Which dog/cat are you interested in ? (Please insert their code or name)



What is the reason for you to adopt a new pet ? *

 As a companion 
 To keep another pet company 
 Guard dog / Security reason 
 Other 

Do you have or had any other pets ? *

 Yes, less than 3 
 Yes, more than 3 
 Used to have, but not now 
 No, never owned a pet 

Is any of your dogs/cats being chained or kept in cage ? *

 Yes, they live in a cage or chained 
 No, I never chain or cage them 
 Only when it is necessary (eg: feeding/bathing time, when we have visitors) 

Do you plan to chain or cage the new dog/cat you adopted from CAS ? *

 Yes 
 No 
 Only when it is necessary 

Are all your dogs/cats sterilized ? *

 Yes 
 No 
 Yes, but not all 
 Only females are sterilized 
 Only males are sterilized 

Do you plan to sterilize this new dog/cat you adopted from CAS ? *

 Yes, definitely 
 No, I dont think it is necessary 
 Yes if it is free 

Do you plan to keep your pet indoor or outdoor ? *

 Indoor 
 Outdoor 
 Both indoor and outdoor 

Does you house have secure fencing and gate ? *

 Yes 
 No 
 We have fence and gate, but it is not secure 

Do you have a proper enclosure to keep the dogs/cats ? *

 Yes 
 No 

Will your new pet be around young children ? *

 Yes 
 No 

Does anyone in your family have pet allergies ? *

 Yes 
 No 
 I am not sure 

Please note that applicants must be over 18 years of age.



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