13780 Highway 69, Savannah, Tennessee 38372
Phone: (731) 926-4008 Fax: (731) 926-3000

 Adoption

Application

Welcome to Horse Creek Wildlife Sanctuary and Animal Refuge. Thank you for your interest in adopting a pet.

The following information is requested so that we can assist you in the selection of your new pet. THE ANIMAL'S WELFARE IS OUR FOREMOST CONSIDERATION. Our process is designed to help us determine if adoption is in the animal's best interest and to assist you in finding an animal most compatible with your lifestyle.

The animals available for adoption came here from a variety of sources. All animals are examined upon entry and animals of appropriate age are spayed/neutered. Their health is routinely monitored, but there is always a chance that an animal is incubating a disease without showing any clinical signs.

Horse Creek reserves the right to refuse adoption to anyone. No animal will be adopted to persons having an extensive history of losing, giving away, or selling animals, or of having animals injured or killed by moving vehicles. No animal will be adopted to prospective owners who mislead or fail to provide accurate information on the adoption application.

IN ORDER TO BE CONSIDERED AS AN ADOPTER, YOU MUST:

* Be 18 years of age or older.

* Have identification showing your present address.

* Have the knowledge and consent of your landlord.

* Be able and willing to spend the time and money necessary to provide food, shelter, medical treatment, appropriate training and proper care for a pet.

You may print and fax this form to (731) 926-3000 or copy, paste and email it to adoptions@horsecreekwildlife.org.

APPLICANT INFORMATION:

Name: _________________________________________________________________

Spouse Name: ________________________________________ Date: _____________

Address: _______________________________________________________________

City: ___________________________________ State: _____ Zip: ________________

Home Phone: ____________ Work Phone: ____________ Cell Phone: _____________

Email Address: __________________________________________________________

Employer: ______________________________________________________________

ADOPTION INFORMATION:

What kind of pet would you like to adopt? ___________ Adult Dog/Puppy

Why do you want a pet? ___________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Do you have any preferences as to breed, sex, age, size, length of hair, etc.?

________ Yes/No

If yes, what are your preferences? __________________________________________

_______________________________________________________________________

_______________________________________________________________________

Is this your first experience with a pet? _______ Yes/No

What pets do you currently have in your household?

 Name

 Type

Spayed/Neutered?

 Kept Where?

Age

______________

______ Dog/Cat

 ______ Yes/No

______ In/Out

______

______________

______ Dog/Cat

 ______ Yes/No

______ In/Out

______

______________

______ Dog/Cat

 ______ Yes/No

______ In/Out

______
______________

______ Dog/Cat

 ______ Yes/No

______ In/Out

______

______________

______ Dog/Cat

  ______ Yes/No

______ In/Out

______ 


List pets owned in the past five years other than those listed above.

 Type

Spayed/Neutered?

 Kept Where?

 What happened to the pet?

_____ Dog/Cat

_____Yes/No

 _____In/Out

________________________________

_____ Dog/Cat

_____Yes/No

 _____In/Out

________________________________

_____ Dog/Cat

_____Yes/No

 _____In/Out

________________________________

_____ Dog/Cat

_____Yes/No

 _____In/Out

________________________________

 _____ Dog/Cat

 _____Yes/No

  _____In/Out

________________________________

Who is your veterinarian? _______________________________________________________

Where do you currently live? _________________ House/Apartment/Condo/Duplex/Mobile Home

Do you own or rent? ______________ Own/Rent

If you rent, does your lease allow pets? ___________ Yes/No

If you rent, what is your landlord's name? _____________________________________________

What is your Landlord's Phone Number? _____________________________________________

How long have you lived at your current address? ______________________________________

How many people live in your household? _____________________________________________

Do all the adults know that you plan to adopt a pet? ____________ Yes/No

If there are children in your household, what are their ages?
______________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

Does anyone living in your household have any known allergies to animals? ______Yes/No

If yes, to what kind(s) of animals? ___________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

Who will be responsible for the care of your pet? ______________________________________

_______________________________________________________________________________

_______________________________________________________________________________

Where will the pet be kept during the day? ___________________________________________

Where will the pet be kept at night? _________________________________________________

How many hours a day will the pet spend without human companionship? __________________

Where will the pet be kept when alone? ______________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

Are you willing to have a Horse Creek representative visit the pet's home? ________ Yes /No

Why do you want a dog? (Check all that apply.)

____House Pet ____Guard Dog ____Watch Dog ____Companion ____Gift ______Company for Other Pet

____ Other: ____________________________________________________________________

Do you have a fenced yard? ______ Yes/No If yes, how high is the fence? _________________

How will you keep your dog confined to your property? (Check all that apply.)

____ In House ____ Kennel ____ Fenced Yard ____ Patio ____ On Chain ____ Garage ____On Leash

Do you realize you may have to housetrain your new puppy or dog? ______Yes/No

What will you do if your dog chews furniture or shows other destructive behavior?

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Will you take your dog to obedience training classes? _______ Yes/No

List two people, not related to you, who would recommend to us that you adopt one of our dogs. (List names, addresses & phone numbers.)

Name: _______________________ Address: __________________________________ Phone: ___________________

Name: _______________________ Address: __________________________________ Phone: ___________________

How did you hear about Horse Creek Wildlife Sanctuary and Animal Refuge?

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

ANY COMMENTS OR SUGGESTIONS?

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

 
 

 

 For immediate information please email: adoptions@horsecreekwildlife.org.

 

 

© 1998-2016 Horse Creek Wildlife