Rainbow Rescues Inc

Adoption Application

Today's Date *
First Name *
Last Name *
Street Address *
City *
State *
Zipcode *
Home Phone
Cell Phone/Alt Phone
Email Address * Enter none if no email address
How did you hear about us?
What type of pet are you interested in? *
Male or Female? *
What breed are you interested in?
Pet's level of training *
What energy level are you interested in? *
What Age? *
Size Of Pet *
Are you interested in a Specific Pet?If you are unsure please leave blank.
Are you interested in another animal listed?
Please describe why you would like a new pet: *
What is your living situation? *
If you rent please provide your landlords name and phone number. Failure to do so will delay the processing of your application.
Do you have a fenced yard? (Please note our adoptable cats are not allowed outside unless labeled as Barn Cats) *
Please note how many people are in your home and their ages. *
Who will be responsible for the pet? *
How Many hours a day would the pet be left alone? *
Please provide Current or Past Vet Name and Phone Number (Please note:To expedite the application process please contact your vet and give them permission to speak with us): * If you have not had a pet in the past 7 years please put NONE
Will this pet be left outside unattended for any reason? *
Please list your current dogs(Name, Age, Breed, Sex): * Please put none if you have no current pets.
Please list current cats (Name,Age, Breed, Sex) * If you had no previous pets please enter NONE
Please list current other pets(Name, Breed, Age, Sex) * If you have no OTHER type pets please enter none.
Please list any pets you have had over the last 5 years (Name, Breed, Sex) * If you have not had any previous pets please enter NONE
BY SUBMITTING THIS APPLICATION, I HEREBY CERTIFY THAT I AM AUTHORIZING RAINBOW RESCUES INC TO INITIATE ADOPTION PROCESSING BASED ON THE INFORMATION PROVIDED ABOVE. I ATTEST THAT ALL INFO PROVIDED TO RAINBOW RESCUES INC IS TRUE AND COMPLETE TO THE BEST OF MY ABILITIES AND FURTHER AUTHORIZE RAINBOW RESCUES INC TO VERIFY INFORMATION PROVIDED THROUGH CONTACT WITH MY PAST/PRESENT VETERINARIAN AND THROUGH CONTACT WITH MYSELF AND CO-APPLICANTS AND ALL PERSONS OR ENTITIES LISTED HEREIN. *