PLEASE READ VERY CAREFULLY BEFORE SUBMITTING YOUR APPLICATION
LASTLY - Please complete as much of the information as you can. This information will be used to evaluate your situation and help us assist you in fostering or adopting the right pet. None of this information will be sold or given to any other organization without your explicit written consent. All information is completely confidential
The Staff of Proverbs 12:10 Animal Rescue
First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone
Cell Phone
Alt Email
YOU MUST BE AT LEAST 24 TO ADOPT FROM PROVERBS. What is your Date of Birth?*
Please provide your FB url
Please provide Instagram url
Please provide Linkedin url
Place of employment?*
How long have you been employed here?*
How did you hear about Proverbs 12:10?*
In which pet are you interested?
Choose from a list of Available Pets on our website. Choose an animal: Abigail Abigail Andy Andy Logan Bailey Boo Beau BlackJack Blanca Boo Bear Bryce Cali Charlee Rose Charlie Cindy Cordelia Da'Shi Dakota Dallas Darcy Delilah Desdemona Easton Eden Edwin Emmett Eric Farah Faye Fiona Fortune Fozzie Bear Freddie Fredrick Ginger- bonded with Skeeter Haidyn Hank (bonded with Henry) Harlow Hattie Henry (bonded with Hank) Isabel Ivan Ivy Java Jess Jess Jessie Joy Bella Kevin Ledger Liam Lyla Maggie Memphis Marie Massika Mr. Peanut Nicky Oakley Odin Patsy Peeka Pink Pearl Rachel Green Rose Apple Rosie Rose Sadie Scout Skeeter- bonded with Ginger Sophia Sugar Plum Tate Tenley Tessa Theo Tia Tiggs Toby Tommy Tori Tori Trevor Trish Ty Tyler Wade Waylon Wendy Westley Westlynn Whiskey Willow Windsor Winnie Wise Guy Wren Yeti Spaghetti
Which pet would be your second choice of available pets? Choose an animal: Abigail Abigail Andy Andy Logan Bailey Boo Beau BlackJack Blanca Boo Bear Bryce Cali Charlee Rose Charlie Cindy Cordelia Da'Shi Dakota Dallas Darcy Delilah Desdemona Easton Eden Edwin Emmett Eric Farah Faye Fiona Fortune Fozzie Bear Freddie Fredrick Ginger- bonded with Skeeter Haidyn Hank (bonded with Henry) Harlow Hattie Henry (bonded with Hank) Isabel Ivan Ivy Java Jess Jess Jessie Joy Bella Kevin Ledger Liam Lyla Maggie Memphis Marie Massika Mr. Peanut Nicky Oakley Odin Patsy Peeka Pink Pearl Rachel Green Rose Apple Rosie Rose Sadie Scout Skeeter- bonded with Ginger Sophia Sugar Plum Tate Tenley Tessa Theo Tia Tiggs Toby Tommy Tori Tori Trevor Trish Ty Tyler Wade Waylon Wendy Westley Westlynn Whiskey Willow Windsor Winnie Wise Guy Wren Yeti Spaghetti
ID #
Are you interested in
Gender Preference
Age Preference Choose one: under 1 yr 1 to 6 yrs 5 to 10 yrs over 10 yrs
Personality Preference
Color preference?
Are you applying to
Is there another Adult in the household?
Please list First Name of Spouse/ Partner
Please List the Last Name of Spouse/ Partner
Cell Phone #
Spouse/Partner Cell Phone Number
Spouse/Partner place of employment
Email address?*
Have all adults in the household agreed to the adoption?
Relantionship?*
Name of Employer*
How long has he/she been employed here?*
Do you have children in your household?
If you answered Yes to children, please provide the age of each child?
If you answered No to children, do you plan to have children in the future?
What would you do with your pet if you have a child? *
What type of Household do you have (check all that apply)* Choose one: Calm Quiet Seldom Visitors coming and going Noisy Active Frequent visitors coming and going
Is anyone in the household allergic to animals?
If you answered yes to the above question, how severe is their condition?
Do you own or rent your home* Choose one: Rent Own
In what type of home do you live Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
How long have you lived at this address?
IF YOU RENT, please enter your landlord's name, phone number, email and when your current lease is up. Your application will not be processed without this information.
Does your landlord have a weight limit for a pet? If so, what is the weight limit?
How many pets are permitted at your home per your lease?
Do you plan to move in the near future? When? *
What would you do with your pet if you moved? *
List at least two references (non-family members) -Must include phone number and/or email address. *
Why are you interested in adopting a pet at this time?*
Any special circumstances you want us to know about?
What traits are you looking for in a pet?
Is this your first experience with this type of pet?
Please list all the pets that you currently have in your home as well as those you have owned in the past 5 years. (We are asking for pets you have personally had the care of, not family pets. If you want to provide info on pets you have experience with, please do so under comments) Include: Name, Breed, Age, Spay/Neutered? Do they live inside or outside? Where are they now?*
Are your current pet(s) up to date on their vaccinations? Please mark all that apply.
Are you able to financially afford to take your pet to the vet should they become ill knowing the bill could be $500 or more?
Have you ever given one of your pets to someone, or surrendered to a rescue or animal control? If yes, please explain:*
Provide the NAME and PHONE NUMBER for your veterinary clinic. *
MANY VETS REQUIRE THAT YOU CALL TO GIVE CONSENT FOR THEM TO PROVIDE US WITH THE INFORMATION REQUIRED TO BEGIN THE REVIEW PROCESS. MAKING MULTIPLE CALLS TO THE VET AND EMAILING YOU FOR INFORMATION TAKES A LOT OF TIME AND CAN DELAY THE PROCESS FOR DAYS OR EVEN WEEKS.
If your current vet has been your vet for less than one year, please provide your past vet information to include name, address, and phone number. *
For cats only: Are you planning to declaw
If adopting a cat or kitten, would you allow the cat or kitten to go outside?
If you also have a dog(s), where will the cat/kitten be when you are not at home?*
Do you have any comments or additional information you would like to share?
This page consists of a set of legal statements concerning the adoption of this pet. ANY ADDITIONS OR CHANGES TO THE TERMS AND CONDITIONS PORTION BELOW WILL INVALIDATE THE CONTRACT. By initialing each statement I am acknowledging and agreeing to each statement as outlined below. We are determined that NONE of our animals EVER ends up being abandoned or in a shelter. In order to honor this commitment, this adoption application, once accepted and signed by both the adopter and Proverbs 12:10 shall be considered a binding contract between the adopter and Proverbs 12:10 Animal Rescue. Breach of this contract will result in the adoption becoming null and void and the pet will be returned to Proverbs 12:10 for rehoming. Further legal action may be pursued should it be deemed appropriate by Proverbs 12:10. Please read this document carefully, and check each statement indicating you understand and agree to this commitment. As an adoptive or foster parent for Proverbs:12:10 Animal Rescue, I agree to:
1. ******************************************* for all intents and purposes to give this pet a “forever” “safe” and “loving” home. I agree NOT to SELL, GIVE AWAY, FORFEIT TO A SHELTER, ABANDON, LIST ON CRAIG’S LIST (OR SIMILAR MEDIA), OR TO USE THIS ANIMAL FOR EXPERIMENTAL PURPOSES, ALLOW HIM/HER TO ENGAGE IN DOG FIGHTING OR PURSUE ANY GUARD DOG or ATTACK DOG TRAINING NOW OR AT ANY TIME IN THE FUTURE. IF I AM NO LONGER ABLE TO CARE FOR THIS ANIMAL FOR ANY REASON, THE ANIMAL WILL BE RETURNED TO PROVERBS 12:10 TO BE REHOMED. I WILL BE RESPONSIBLE FOR ANY COST INVOLVED IN RETURNING THE ANIMAL TO PROVERBS 12:10 AND UNDERSTAND THERE IS NO REFUND OF THE ADOPTION FEE. (THE SPAY/NEUTER DEPOSIT WILL BE RETURNED IF THE PET IS UNDER THE AGE OF 6 MOS. OR WAS SPAYED/NEUTERED BY THE AGE OF 6 MOS) FAILURE TO ABIDE BY THIS CONDITION OF ADOPTION WILL RESULT IN LEGAL ACTION AND ADDITIONAL FEES OF UP TO $500 TO COVER THE COST OF RECOVERY AND OTHER EXPENSES INCURRED TO REHOME THE ANIMAL WILL BE SOUGHT. ***************************************** *
2. I understand if it is determined this pet has not been spayed or neutered because it is too young, I will have him/her spayed or neutered before he/she reaches the end of its sixth month of age. I understand I am responsible for the COST of this procedure. I understand A SPAY/NEUTER DEPOSIT in the amount of $150, will be provided to Proverbs 12:10 Animal Rescue at the time of adoption for all pets that have not been spayed/ neutered prior to adoption. This deposit is in addition to the adoption fee and will be held until such time adequate documentation is provided showing that the animal has been spayed/neutered. Once this documentation has been received, the deposit will be returned to the adopter. If this documentation is not received within 30 days of the animal reaching 6 mos of age, the check WILL be cashed and I will be in violation of this agreement and the adoption will become null and void. *
I agree that I will not have this cat/kitten declawed for any reason. I understand that declawing involves not only the amputation of the claws, but also the amputation of the phalanx (up to the joint) including bones, ligaments, and tendons and that declawing can cause serious physical, psychological and behavioral issues. I understand that scratching is a normal cat behavior. FAILURE TO ABIDE BY THIS CONDITION OF ADOPTION WILL RESULT IN LEGAL ACTION AND ADDITIONAL FEES OF UP TO $500 TO COVER THE COST OF RECOVERY AND OTHER EXPENSES INCURRED TO REHOME THE ANIMAL WILL BE SOUGHT. *
3.SHOULD THIS BE A FOSTER TO ADOPT – I understand a deposit in the amount of the adoption fee during the one-week foster period is required. The deposit will be held until our agreement is finalized. However, should the pet not be returned or the adoption finalized following this foster period the deposit will be forfeited. We shall make every attempt to contact/ locate you, however failure to respond to our calls and/or e-mails will violate this contract and may result in legal action.*
4. to provide proper and adequate food, water, housing, exercise and grooming for this pet and to treat him/ her humanely at all times – (adequate housing is defined as living inside your home, never to be tied or left outside, especially during inclement (ie: above 82degrees or below 32 degrees) or stormy weather).*
5.to provide veterinary care in the form of vaccinations, preventative heartworm medications, flea/tick preventative as appropriate, and such veterinary care as is necessary to prevent and/or treat accidents and illnesses. Costs may be from $100 up to $2000.00.*
7.my place of residence in a home, apartment, condo, townhouse, public housing complex or other housing complex allows for ownership and occupancy of the pet I am adopting and the pet will live in my residence. *
8.I have been informed that all animals can carry and transmit diseases, some of which affect people including bacteria, viruses, parasites and ringworm and that these diseases may be undetectable in what appears to be a healthy animal at the time of adoption*
8. I have read this agreement and release Proverbs 12:10 Animal Rescue from any present or furture liability associated with my adoption of this pet. *
10.Proverbs 12:10 Animal Rescue is in NO WAY RESPONSIBLE for any damage the animal may inflict on another person, my property, or the property of another, and no attempt will be made by me to hold Proverbs 12:10 Animal Rescue responsible.*