ADOPTION APPLICATION

this should only be used if the “fillable” one on the FORMS page isn’t working.

Print (ctrl-P) and Save to your computer, send to the email address with the animal’s bio.

Dog or Cat Adoption Requirements

  1. Applicants for animal adoption must be at least 18 years of age.
  2. All applicants must furnish two personal references.  Please, no family members
  3. Applicant must agree to abide by all the animal ordinances establishing the care, control and registration standards for animal ownership within the city they live.
  4. All animals over 6 months must have appointment for the animal to be spayed or neutered before the adoption transaction is complete. (Arkansas State Law; A.C.A 20-19-103) If the attending veterinarian chooses to postpone the spay/neuter surgery due to medical concerns the adopting party must agree to return the animal to the attending veterinarian at the specified time for surgery.  For animals under the age of six months, the spay/neuter surgery will be scheduled to take place when the animal reaches the age of six months; the adopting party must agree to bring the animal to the attending veterinarian at the specified time for the spay/neuter surgery.  Pre-payment of spay or neuter is included in this adoption fee.  IF SCHEDULED APPOINTMENT IS MISSED, OUR OBLIGATION TO PAY IS VOIDED, AS WE PAY FOR SURGERY SPOT.  LAW REQUIRES SURGERY STILL BE DONE, BUT THIS WILL BE AT YOUR EXPENSE, WITH PROOF SENT TO Tailwaggers21@gmail.com YOU MAY USE YOUR OWN VET AND WITH PROOF SENT TO US, MAY REQUEST A REFUND OF $50.00 FOR DOG AND $30.00 FOR CAT. YOU MAY CHOOSE TO DONATE TO THE RESCUE.
  5.  Very young children and small puppies or kittens do not always mix and children are often bitten or scratched as a result of inadvertently holding or picking up a young animal in the wrong way.  In households where there are children under the age of 6 years, applications for adoption of puppies under 5 months of age shall be evaluated by the following guidelines:
  6. Compatibility between the child and the animal, which will be evaluated by staff prior to adoption.
  7. The child’s previous experience with other animals.
  8. Puppies (aged five months and younger) are generally not adopted into a home where there is no one home during the daytime for more than five consecutive hours.  A puppy needs to be socialized with people on a consistent basis in order to become a good companion.  A puppy cannot learn to be house trained if there is no one home to take him/her outside for training.  Puppies are like children – they need the supervision to teach them right from wrong.  Applicants who cannot be home to train a puppy are encouraged to consider adopting an older animal.
  9. Applicants who rent their home/apartment we must receive verbal permission from the landlord or owner of the residence. We must receive verbal permission from the landlord within 24 hours of the application being filed.  If not received within that time, we will cancel the application and make the animal available for adoption.
  10. If for any reason the adoption is not successful, or the owner cannot keep the pet, your more than welcome to contact us and see if a spot is open but it is rare we have open slots.  We recognize that not every pet adoption will be successful through no fault of the person or the pet, however if this time is greater than 2 weeks, a Surrender Fee of $50.00 is required if we are able to take back..  This is a non-refundable transaction. We will also need 48 hours notice before the animal is returned. 
  11. Dogs are placed as companion animals, not as guard dogs.
  12. Adoptions are a commitment, therefore Adoption Fees are non-refundable.
  13. Please retain a copy this form for your records.

I agree to the above requirements and wish to adopt a pet.

Signature: ______________________________________________                  Date: ____________________________________

Cash/check/credit PayPal (circle one)             Adoption Fee $________________  

Tailwagger Representative: ________________________ date received ________________

Adoption Application & Profile

Welcome to Tailwaggers NWA, a 501c3 rescue organization.  We are pleased that you have decided to give a homeless animal a second chance.  The purpose of our adoption program is to find responsible homes for animals suitable as family pets.  Thank you for filling out this profile.  The information you provide will help us help you to find the best pet for you and your family.       

Name (please print) _____________________________________________________________

Address______________________________________________________________________

City______________________________________ State___________ Zip_________________

Employment_________________________________________________________________

Driver’s license #_____________________State_____Date of birth______________

Home phone_________________________ Workphone_______________________________Cell phone_______________________ Email: ____________________________________

Housing (Check all that apply):  oOwn    oRent     oLive with Parents     oMilitary     oStudent    oApartment    oHouse     oMobile home     oCondo/Townhome     oFenced Yard     oUnfenced Yard    oDog Run     oNo Yard

If you rent, Tailwaggers NWA must receive Verbal permission from your landlord. 

If we do not receive verbal permission by ______________ your application will be cancelled.

            Landlord’s Name ______________________________________________________________

            Address              ______________________________________________________________

                                  Phone__________________________

References 

Please provide two (2) references,  (not a family member) who we may contact between the hours of 8 am and 5 pm:

            Name   _______________________________               Name             _______________________________

            Address ______________________________                Address ______________________________

            Work/Cell Phone   _______________________              Work/Cell Phone   _______________________

Animal’s name that you are wanting to adopt: ______________________________________________

                                                                You and Your Household

  • Are you          o A first time pet owner?     o Have owned pets in the past.
  • My family consists of: Adults #____________ Children #_____________
  • Ages ____ _____ _____ _____ _____
  • Is anyone in the house allergic to animals?   oYes  oNo
  • Who will be responsible for the pet? ____________________________________________________________
  • Where will your pet spend the day? _________________________ The night? __________________________       
  • Are they currently registered with any city?  oYes  oNo   City__________________Tag#________
  • If you move in the future, what will you do with your pet? ___________________________________________
  • How much time would you allow your new pet to adjust to your family and/or present pets? _________________
  • Have you considered the daily expenses for maintaining an animal (Medical, food, grooming, etc.)?  oYes  oNo
  • Are you familiar with humane procedures for house training? oYes  oNo
  • If a behavior problem arises, are you prepared to invest the time and expense for training?   oYes  oNo

Please list all pets currently at home and any that you have owned in the past three years.

Pet’s NameMale or FemaleCat or DogBreedAgeIs the Pet Spayed/ Neutered?Where is the pet kept?What Happened to the Pet?
        
        
        
        
        

Name and phone number of your veterinarian ________________________________________________________

By signing below, I certify that all above information will be found true, and any misrepresentation of any fact may result in denial of adoption. I acknowledge and understand completely that all pets up for adoption are the sole property of Tailwaggers NWA.  I Authorize investigation of all statements I have provided on this application. I also understand that an authorized representative of Tailwaggers NWA may contact me in the future to follow up on the success of this adoption.  

Applicant Signature: ____________________________________ Date: _____________________  

Dog or Cat Adopting __________________________

Check/Cash/credit PayPal (circle one)          Amount __________Copy of Driver’s License___________    

Animal rescue working with Siloam Springs, W. Siloam Springs, Gravette & Decatur Animal Shelters and Paws Place in rural Colcord.

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