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Animal You would like to adopt
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Name
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Age
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Address
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Zip
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City
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State
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Home Phone
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Email
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Occupation or other source of income
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Work Phone
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How long have you lived there
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Do You own or rent
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If yes please explain below
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If you rent does your lease have an animal clause
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Are there any local laws regarding reptile where you live
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If yes please explain below
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Please list all other pets/animal currently in your home
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Please list all species of reptiles you have had in the past and where they are now
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Have you adopted an animal before
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If yes please tell us the type of animal, the current status of the animal, and the name and contact info for the rescue/shelter you adopted from
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Have you ever surrendered an animal to a shelter or rescue
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If yes please tell us the type of animal, the reason for surrender and the contact info for the rescue/shelter
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What kind of reptile work or hobby experience do you have
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What type of enclosure so plan to keep this animal in, be specific (Dimension's, lighting, substrate, etc)
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How many adults are in your household
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How many children are in your household
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Children's ages
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Who will be the primary caretaker of this animal
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Why do you want to adopt this animal
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Do you plan to breed this animal
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If yes, do you have experience breeding reptiles
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If you breed what will you do with the offspring
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Do you currently have a reptile vet
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If yes, please give the contact information below
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Vet's name
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Vet's phone number
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If no would you like us to help you find a reptile vet
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Please provide three reference below
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Name
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Phone
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Length of time known
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How you know them
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Name
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Phone
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Length of time known
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How you know them
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Name
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Phone
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Length of time known
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How you know them
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Is there anything else you would like us to know when considering you application
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BY CLICKING SUBMIT, I ATTEST THAT ALL STATEMENTS MADE ARE TRUE AND CORRECT.
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