WELCOME TO WHIMSICAL ANIMAL RESCUE/SUSSEX COUNTY ANIMAL ASSOCIATION

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone

Alt Email

***PLEASE READ CAREFULLY*** ALL OUT OF STATE ADOPTERS ARE REQUIRED TO HAVE A VET REFERENCE. This means that you either have a current or previous pet that a vet history can be obtained for. If you are a Delaware resident either a vet reference and/or home inspection is required. If you live out of state and DO NOT have any veterinarian references we cannot approve your application and suggest you check with a rescue in your area: By selecting yes you are stating that you understand this and are giving us the okay to contact your veterinarian to obtain this reference.*
Choose one: Yes No

Which Animal are you most interested in
Choose an animal: Abbott Artemus Austin Brine Brisket Cowcifur Dezi Dioge Dolly Elroy Flower Gidget Honey Dip Ice Ilene Indigo Ivan Jammi Lou Jazz Johnny Rotten Johnny Rotten London Lucyfur Macquire Mimi Mocha Leigh Mona Lisa Paris Quill Rose Shine Twister TY Unique WORKING CATS

Is there another animal you are interested in
Choose an animal: Abbott Artemus Austin Brine Brisket Cowcifur Dezi Dioge Dolly Elroy Flower Gidget Honey Dip Ice Ilene Indigo Ivan Jammi Lou Jazz Johnny Rotten Johnny Rotten London Lucyfur Macquire Mimi Mocha Leigh Mona Lisa Paris Quill Rose Shine Twister TY Unique WORKING CATS

List at least one reference (who is not a family member) Name and Phone number*

Veterinarian's Name and Phone Number*

If you have children what are their ages?*

Does anyone in your family have allergies that could be pet related?*

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home*
Choose one: Rent Own

If you rent, have you received the approval of your landlord to have an animal
Choose one: Yes No

If you rent, please enter your landlord's name and phone number

Is your yard fenced*
Choose one: Yes No

What type of fence

What is the height of the fence

Will the animal be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

Where will the animal be kept when you are not home*

Where will the animal be kept when you are home*

Where will the animal sleep*

How much time during the day will the pet be alone*

list your current pets: name age breed spay/neutered/ *

List your previous pets Name Breed Age*

Some puppies/kittens under the age of 6 months and smaller then 3 pounds may not be altered. There is a state required deposit of $75 which will be returned once the pup is altered at 6 months. Do you understand that this is a requirement and that you will have to comply?*

Have you ever given up a pet? If so please explain?*

If you move, will your pet go with you*
Choose one: Yes No

Have you applied with any other rescue*
Choose one: Yes No

If you did apply to another rescue, what was the name of that organization

Are all your current pets spayed/neutered*

Have you ever had a dog/puppy on your premises with parvo/distemper or die on your property from unknown reasons. If so please explain.*

Is there anything else you would like to ask or tell us? If so you can do so here.*

Who in the household will care for the pet*

Please indicate the age of each member living in home including yourself*

Who will care for your pet if something happens to you that leaves you unable to care for them any longer? ex injury, health etc.*

I certify that the information entered on this application is true and that I am at least 18 years of age. Enter your name and date:*