Online Adoption Application

To complete your adoption application online please complete the entire form below and click "Submit":

Identification

 

Name*

 

Street Address*

 

City*

 

State* Select State AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IO KS KT LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY N ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

 

ZIP*

 

Home Telephone No.*

 

Employment Information

 

Employer*

 

Position*

 

How long employed*

 

Business Telephone No.*

 

Lodging Information

 

Type*

Rent
Own

 

If you are a renter:

 

Landlord's Name

 

Landlord's Telephone No.

 

I have a yard*

Yes
No

 

My yard is fenced*

Yes
No

 

Household Information

 

No. of ADULTS in household*

 

No. of CHILDREN in household*

 

Ages of children

 

Roommate/Spouse's Name

 

Are you in favor of neutering?*

Yes
No

 

Have you adopted or applied for adoption from Morris before?*

Yes
No

 

If yes, date:

 

Have you brought animals to Morris before?*

Yes
No

 

If yes, date:

 

Explanation

 

Pet History

 

I am interested in adopting a*... Select Option Cat Dog Other

 

List the animals by name which have been part of your family during the last 10 years. Indicate the status of each using the codes below:

 

• Pet 1
• Pet 2
• Pet 3
• Pet 4
• Pet 5
• Pet 6

Pet 1

Pet's Name

 

Pet's Species Choose Option Dog Cat Other

 

Pet Status Select Status Still With Me Died Placed In Another Home Lost/Ran Away Stolen Turned Into Shelter Euthanized Sold With Parents

 

How many litters has the above animal had:

 

Veterinarian's Name or Practice

 

Veterinarian's Telephone No.

 

Pet 2

Pet's Name

 

Pet's Species Choose Option Dog Cat Other

 

Pet Status Select Status Still With Me Died Placed In Another Home Lost/Ran Away Stolen Turned Into Shelter Euthanized Sold With Parents

 

How many litters has the above animal had:

 

Veterinarian's Name or Practice

 

Veterinarian's Telephone No.

 

Pet 3

Pet's Name

 

Pet's Species Choose Option Dog Cat Other

 

Pet Status Select Status Still With Me Died Placed In Another Home Lost/Ran Away Stolen Turned Into Shelter Euthanized Sold With Parents

 

How many litters has the above animal had:

 

Veterinarian's Name or Practice

 

Veterinarian's Telephone No.

 

Pet 4

Pet's Name

 

Pet's Species Choose Option Dog Cat Other

 

Pet Status Select Status Still With Me Died Placed In Another Home Lost/Ran Away Stolen Turned Into Shelter Euthanized Sold With Parents

 

How many litters has the above animal had:

 

Veterinarian's Name or Practice

 

Veterinarian's Telephone No.

 

Pet 5

Pet's Name

 

Pet's Species Choose Option Dog Cat Other

 

Pet Status Select Status Still With Me Died Placed In Another Home Lost/Ran Away Stolen Turned Into Shelter Euthanized Sold With Parents

 

How many litters has the above animal had:

 

Veterinarian's Name or Practice

 

Veterinarian's Telephone No.

 

Pet 6

Pet's Name

 

Pet's Species Choose Option Dog Cat Other

 

Pet Status Select Status Still With Me Died Placed In Another Home Lost/Ran Away Stolen Turned Into Shelter Euthanized Sold With Parents

 

How many litters has the above animal had:

 

Veterinarian's Name or Practice

 

Veterinarian's Telephone No.

 

Additional Information/Comments

 

How did you hear about Morris Animal Refuge?

 

By submitting this form online, I authorize Morris Animal Refuge to contact:

• My/our veterinarian(s) to check the care provided to previously and/or currently owned pets, and to check the spay/neutering history;
• My landlord(s) to ensure that I have the owner's permission to keep pet(s) on the premises;
• My/our employer to confirm employment.

I certify that the statements made on this application are true and accurate to the best of my knowledge. I understand that false statements, either written or oral, may lead to the rejection of this application for pet adoption.

 

 

** If you're having trouble submitting this form, don't forget to scroll up in case a required field was left blank. **