Address Including Unit or Lot Number, Town, State and Zip Code *
Your answer
Applicant Phone Numbers *
Your answer
3 Personal References: (only 1 relative) with phone numbers and what your relationship is. *
Your answer
Is this animal intended to be a gift *
Required
Number of Children in Household with Ages *
Your answer
How many animals have you had in the last 5 years? *
Your answer
If the pets are not with you where are they? *
Your answer
How many pets do you have now? (dogs, cats, other) *
Your answer
Are all current pets spayed/neutered/ up to date on vaccinations? *
Required
If Not Why? *
Your answer
Name of Vet with Phone Number. *
Your answer
Name and Pet Names on Vet Account *
Your answer
Have you ever surrendered an animal before? If so Why? *
Your answer
Do you own or rent your home? Confirmed thru assessor records. *
Required
If Renting we need your landlords name and phone number
Your answer
Do you live with a friend or relative? If yes what is their name and phone umber? *
Your answer
Do you know of any pet restrictions? *
Your answer
If you need to move what do you plan on doing with pets? *
Your answer
How many hours a day will pet be alone? *
Your answer
Do you plan on keeping pet *
Required
Are you and your family prepared for possible chewing, clawing, scratching, litter training, (etc)? *
Required
Are there any conditions in which you would surrender your pet, for example, Allergies, Trouble Litter Training, Cries too much, chews on things, unruly behavior, or bites someone? Other please explain. *
Your answer
What are your thoughts on “declawing” or “claw caps”? *
Your answer
What is your plan for vacations/emergencies/ or your untimely demise for the care of the animal? Do you have a back up plan? If so what is the plan? *
Your answer
Are you willing to give the pet some time to adjust to the new home? This may take up to 3 - 4 weeks. *
Your answer
SNAP of MI does everything to ensure an animal is healthy but normally their background is unknown. Are you able to provide extra care if a problem arises? *
Required
Date of Application *
MM
/
DD
/
YYYY
Applicant and Co-Applicant Signature *
Your answer
A copy of your responses will be emailed to the address you provided.