Contact Information-Photo ID is RequiredWhat is the name or type of pet you are interested in adopting?*Email* Name* First Last Date Date Format: MM slash DD slash YYYY Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Occupation*Place of Employment*Date of Birth*Driver's License Number (copy required to adopt)*Driver's License Copy May Be Uploaded Here or Bring with You to ShelterHave you ever been arrested?*YesNoIf yes, what state (s)?If yes, please explain belowHouseholdDo you rent or own your home?*Does your home have any size or breed restrictions?*YesNoDoes your landlord allow pets?Do you have a fenced yard?*Renters and/or Homeowners Association: Please Provide Landlord/HOA Name and Contact Number.How many people live in your household*Ages of children under 18:Are they any children who visit regularly (partial custody, grandchildren, etc.)?*YesNoName of all adults living in the home:*Do you live in a:* House Apartment Townhome Condo Have you ever adopted a pet before?*YesNoIf yes, where?How many hours per day will your pet be home alone?*Where will your pet stay when you are not at home?* Outside (fenced yard) Outside (chained) Inside confined Inside Loose Crate List pets you currently have and their age*Current Veterinarian Name & Contact Information*List two personal references with contact information*Is there anything else you would like us to know?* By Checking This Box I Agree with the Adoption Guidelines Listed on our Website. * By Clicking Submit you are stating that all of the information given in this application is true and accurate to the best of your knowledge. IMPORTANT THINGS TO READ AND UNDERSTAND BEFORE SUBMITTING YOUR APPLICATION The Edgewater Animal Shelter reserves the right to refuse any adoption in which it determines it is not in the best interest of the pet. By submitting this form you are indicating that you have read and understood the information on this application, all of the information submitted is true, and understand that any false information could result in forfeiture of the animal. The Edgewater Animal Shelter reserves the right to perform home checks and follow up visits on the adopted pet(s) at any time, with or without warning to you, the owner. The Edgewater Animal Shelter reserves the right to repossess the pet if there is any evidence it is not well cared for or is living in dangerous circumstances. The Edgewater Animal Shelter reserves the right to conduct a background check on all adopters. There may be a 24-hour hold on the adoption until the background check is complete and the application is approved. An adopter may not adopt an animal to give as a “gift” or otherwise give away. All adopters must fill out an adoption application and sign an adoption contract. Please understand if you adopt a pet from the Edgewater Animal Shelter you accept the pet “as is” and you assume all risks of ownership, including all financial obligations. Should you no longer be able to care for your adopted pet, Edgewater Animal Shelter requires you to return the pet to us. This iframe contains the logic required to handle Ajax powered Gravity Forms.