Thank you for your interest in adopting one of our animals! This form is the first step you need to take to meet an animal in its foster home or to adopt an animal you have already met.

Please review our adoption information page if you have not already done so.

We are an all-volunteer organization, so please be patient – you will be contacted within a few days.  If you are having difficulties, please save your progress and contact us via info@animalrescue.net.

The information in this form will only be used for the processing of this application and can only be seen by the adoption team and foster parent(s) of the animal you are applying for. Thank you again!

NOTE: Please be aware that Independent Animal Rescue is an organization of volunteer foster homes, located primarily in the Durham/Chapel Hill area of North Carolina. Due to the nature of our adoption process, we can only consider applications for homes located within 60 miles of Durham. Thank-you!

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Errors:

• Basic Info
• New Pet
• Home
• Daily Care
• Pet History

• Type of animal you are interested in: Dog Cat
• Name or breed of animal you are interested in:
• Adopter Full Name:
• Adopter Age:
• Address 1:
• Address 2:
• City:
• State: Select one... NC VA other
• Zip Code:
• Is this address within 60 miles of Durham? Select one... yes no
• Primary Phone:
• Other Phone:
• Email address:
• Preferred method of contact: Select one... primary phone other phone email
• How did you hear about IAR? Select one... Indy Ad PetSmart Website Petfinder AniMall Other
• I am a US citizen: yes no
• Please select best description for citizenship: Select one... green card student visa work visa permanent resident other
• Are you planning to move overseas or out of the country at any time? yes no
• Confirm email:
• I am at least 21 years of age. All of the information I have given is true and complete. I understand that IAR has the right to refuse my application: yes no

• When did you decide to get a new pet?
• What qualities are you looking for in a pet?
• What is the intended purpose of this pet? (check all that apply):

  Companion for myself or family
  Companion for another pet
  Mouser
  

  Guard Dog
  

  Gift for:

  
  Other:
• Describe what a typical day will be like for this animal if he/she is adopted by you:
• Do you have any objections to letting a rescue group volunteer visit your home for a pre-adoption visit or follow-up visit after the adoption? no yes


• Please explain:
• If adopting a cat from IAR, do you plan on declawing? yes no
• Please explain

• What kind of home do you live in? Select one... Single Family Detached Condo/Townhome Apartment Other
• How long have you lived at your current address?
• Years:
• Months:
• Do you own or rent your home? own rent
• Do you have permission from your landlord for a pet? yes no not applicable
• Your landlord’s name:
• Your landlord’s phone number:
• May we have your permission to contact your landlord? yes no not applicable
• Do you have a fenced yard? yes no
• How high is the fence?
• Does it touch the ground? yes no
• If there is a gate, is it locked? yes no
• How many members of your household, other than yourself (including family/roommates/frequent visitors, 0 if none) ?

• List all members ( son/daughter/descr instead of name if under 18 ) :

  Name Age Relationship Inhabitants Select one... Household Member Frequent Visitor

• Does everyone agree to getting a new pet? Select one... yes no do not know
• Does anyone listed have pet allergies? yes no
• Please describe allergies and how you manage ( or plan to manage ) if adopting:
• Name of a personal reference (other than family/household member or vet):
• Your reference’s phone number:
• Your relationship to the reference:

• Who will be the primary caregiver of your animal?
• How long are you gone each day?
• Where will your animal stay while you are gone during the day?
• Are you employed? Select one... not employed Full Time Part Time Work at home Retired Undergrad Student Graduate Student non-Active Military Active Duty Military
• How far is your job/school from home?
• What kind of lifestyle do you want your new pet to have? Select one... Indoor only Outdoor only Indoor and Outdoor
• What is your reason for this choice?
• Where will the animal sleep at night?
• How often do you travel?
• When you travel, who will care for your animal?
• How will you exercise your dog?
• How often will you exercise your dog?
• How much responsibility will your child/children be given in the care of the animal? Select one... Total Some Minimal none not applicable
• What will happen to the animal if you move?
• What will happen to the animal if you have children?
• How would you teach your animal?
• What would you do if your animal developed behavioral problems?
• Are you willing to take your animal to a veterinarian for an annual physical and vaccinations? yes no
• Are you willing to provide regular flea and tick control? yes no
• Are you willing to provide monthly heartworm protection? yes no
• I understand the minimum medical costs for yearly checkup and vaccinations are at least $150: yes no
• I understand the monthly costs of food and flea/heartworm preventative: yes no
• I am prepared to pay the adoption fees for this animal: yes no
• I am prepared to make a 20 year commitment to this animal: yes no

• Have you ever owned any other pets as an adult? yes no
How many pets have you owned?
Please list your pet history (current animals first):
Name	Type	Breed	Age (yrs)	Location Kept:	Spay/Neutered?:	Current on Vaccinations?:	What Happened to pet:
	Select... dog cat other			Select... Indoor Outdoor Both	Select... yes no	Select... yes no NA	Select... lives at home re-homed deceased ran away other
Please provide specifics of deceased pet(s) cause of death:
Have your dogs been kept current on heartworm preventative? yes no
Please explain
Have your cats been declawed? yes no
Please explain
If you still own your cat, is it FIV / Feline Leukemia negative? yes no
Have you ever had to relinquish a pet? yes no
Please explain
May we contact your veterinarian? yes no
Veterinarian’s name (or office):
Veterinarian’s location (City,State):
Veterinarian’s phone number:

save and continue

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submit final form

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