Sylvan Lake & Area Serenity Pet Shelter Adoption Application Form

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We are a registered non-profit society and a registered Canadian Charity. Our goal is to build a permanent no-kill shelter. Sylvan Lake and Area Serenity Pet Shelter Society consists of a small group of volunteers who work diligently to rescue, rehabilitate and re-home canines and felines needing our help. As a non-profit organization, we provide rescue services when needed, to dogs and cats for a variety of reasons including trauma, abandonment, or surrender in Sylvan Lake and other areas in Central Alberta and place these animals in the safety of a foster home system while awaiting suitable placement in forever, adoptive homes. Please give careful consideration to adopting an animal. Animals are not novelties, toys or short-term commitments. Make sure your lifestyle allows for the time, patience and expense that this animal will need over the years. Steps for Adopting from Serenity: 1) Begins with an inquiry by phone, text, email, or Facebook. 2) Adoption application form is sent via email to you or you can complete it online. 3) You return the completed form electronically. Please answer all questions. 4) Your application is reviewed. We may contact you to clarify any concerns or expand on any information. 5) We select the application(s) that are best suited to the pet and arrange to have a meet and greet at the foster s home. 6) Meet and greet is held, applicant and pet(s) get to interact. 7) We make the final decision. Please bear in mind that we try our hardest to match families and pets for the best outcome. It is not that one application is better than another - just that one is best suited to this particular pet. 8) The last step occurs when we deliver the pet and complete the home visit. At this time the adoption agreement is signed and the adoption fee is paid. Serenity s policies and procedures include: 1) Vaccinations to date for all pets, de-worming and vet checked. 2) Spay or neuter of all qualified animals. This is based on our veterinarian s advice. 3) All pets are micro chipped and receive 6 weeks of free insurance through Pet Watch. 4) All rescued animals have had all necessary medical care up to date, including surgery for injuries when necessary. 5) Our normal fees for altered dog or puppy $400. and altered cat or kitten $175. 6) Special circumstance pets may require changes to our normal policies and fees. In that case, we carefully discuss and will have additional documentation. SLSPS-Adoption App 09/14/16 REV.01 Page 1 of 8

Date: Applicants Name: Date of Birth: Occupation: Name of animal you are applying to adopt: Address: Postal Code: City: Province: Please include physical address if different from mailing address: Phones: (H) (W) (C) E-mail: Length of time at this address Do you own or rent? If you rent, please provide your Landlord name and phone number: Please describe your home and yard: Farm / Acreage / House / Duplex / Apartment / Townhouse / Mobile / Condominium What kind of space will your pet have access to? Fenced Yard / Dog House / Dog Run / Cat Run Will there be any part of your home that pets would not be allowed? SLSPS-Adoption App 09/14/16 REV.01 Page 2 of 8

Where will the pet sleep? Where will the pet spend most of its time? What will you do with them when you are at work or not at home? Have you ever owned a pet before? Yes If yes, what type: Do you currently have pets? Yes Please list below: Type Breed Age Altered Vaccinated Indoor/Outdoor Dog/Cat/Other Yes / Yes / In / Out / Both Dog/Cat/Other Yes / Yes / In / Out / Both Dog/Cat/Other Yes / Yes / In / Out / Both Dog/Cat/Other Yes / Yes / In / Out / Both Dog/Cat/Other Yes / Yes / In / Out / Both Would you object to a visit or call from us to follow up on how you and your new family member(s) are doing? Yes Please list two references (name, relationship, phone number) 1. 2. Why do you want to adopt? Please Check: Gift for someone Companion for myself/family Watch dog Guard dog Companion for other animal To breed SLSPS-Adoption App 09/14/16 REV.01 Page 3 of 8

Are you familiar with crate/kennel training? Yes What are your thoughts on it? Will you be using a crate/kennel as a form of punishment? Yes How long would your pet be kept in a crate/kennel at any one time? What do you think are the most important responsibilities in owning a pet? Are you willing to take the time to work with an animal on housebreaking issues should the need arise? Yes Are you willing to take the animal to training classes? Yes Do you understand that changing an animals environment may cause it to have accidents, hide, hiss, and be under duress in the early days of adoption? Yes How will you ensure your pet does not wander from your property? Circle all that apply: Keep in House / Keep in Garage or Barn / Keep on chain or leash outside / Keep in outdoor Kennel / Fenced Yard / Other Describe you might respond to Kitten/Puppy mistakes such as furniture scratching, chewing on items (shoes, furniture etc.) biting, soiling on floors? Have you ever had to surrender/give away any of your pets? Yes SLSPS-Adoption App 09/14/16 REV.01 Page 4 of 8

For what reason? Do you have experience handling and training animals? Yes Do children frequently visit your home? Yes Is your household equally enthusiastic about adopting a pet? Yes In the absence of the primary care giver, who will take care of the pet? Are you comfortably able to provide the estimated care for your pet as well as any emergency cost that may occur? Yes Estimate what you think the monthly or yearly cost to maintain your pet would be: - Food - Grooming - Obedience Classes - Vaccinations - Eye, Ear, Dentals & Emergencies - Beds, blankets, toys Please comment on the phrase getting rid of as it refers to pets: Marital Status: Married / Single / Divorced / Widow(er) / C/L SLSPS-Adoption App 09/14/16 REV.01 Page 5 of 8

Other family members: (please include children s ages) Does anyone in your family have allergies to pet hair? If yes, please explain. How busy is your family schedule? Very Busy / Busy / t busy/ other How would you describe the activity level in your household? For example, do you walk daily? Have you ever owned a pet before? Yes Do you still have that pet? Yes If no, please explain: Do you have any pets now? Please describe, including type, gender and ages, and whether they are spayed or neutered. Are there any restrictions or covenants where you live? SLSPS-Adoption App 09/14/16 REV.01 Page 6 of 8

Of all the applications we receive for adoption we can only chose one. The pet is placed in the most suited home. It you are not the successful applicant, please do not be discouraged. The next pet may be perfect for you. Please check the following if you applying to adopt a dog/puppy: I would like my dog to: Be friendly with children Be friendly with other dogs Be friendly with cats Be calm Be playful Other: please list Very Important Quite Important t Important Some dogs require special training: Yes t sure I need a dog that is already trained. I am a first time dog owner I have experience in obedience SLSPS-Adoption App 09/14/16 REV.01 Page 7 of 8

Adoption Agreement I agree that the animal being adopted is for myself and will not be sold, adopted or given to another party. (if adopting a dog/puppy) I agree that this dog/puppy is to be a companion animal; not a guard dog trained to attack and that the dog will live inside my home. I agree to care for the animal in a humane manner. This includes supplying adequate food, water, shelter, attention and medical care. I agree that if at any point I cannot keep the animal I will surrender him/her to Sylvan Lake & Area Serenity Pet Shelter Society without requesting a fee or refund. I agree that Society may call and/or visit my home to check on the adjustment and progress of this animal. I agree that the dog will not wear a pinch (prong) collar or any similar article around the neck for the purpose of any basic training. I agree to keep this pet healthy with proper nutrition and veterinary care and to keep this pet safe from all harm. I take full responsibility for any damages that occur as a result of the natural growing and adapting process of this pet. I have read the above information carefully and have filled out this application honestly. I understand that omission of information can result in this application being declined. I agree if the above terms are not met, has the right to reclaim the pet without notice and without refund. Date: Signature of adopting Parent: Signature of Serenity Representative: Witness: tes: SLSPS-Adoption App 09/14/16 REV.01 Page 8 of 8