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Animal Control and Rescue Adoption Application

2. <p align="center">St. Joseph Animal Control and Rescue Adoption Application and Worksheet<br> 701 Lower Lake Rd. St. Joseph, MO 64504 Phone: (816) 271-4877 Fax: (816) 271-5362<br> St. Joseph Animal Control and Rescue reserves the right to refuse an adoption.</p>

   St. Joseph Animal Control and Rescue Adoption Application and Worksheet
   701 Lower Lake Rd. St. Joseph, MO 64504 Phone: (816) 271-4877 Fax: (816) 271-5362
   St. Joseph Animal Control and Rescue reserves the right to refuse an adoption.

4. Have you selected a specific animal?*

   1. Yes
   2. No

6. Animal Log #

7. Animal Description

9. The animal log number of the pet you wish to adopt must be listed on this application if you have selected a specific animal.

11. Your Name*

12. Date of Birth*

14. Phone*

15. Address*

17. City / State / Zip*

19. Email Address*

21. Application Questions:

23. 1. Have you or anyone in your household been convicted of animal abuse/neglect?

    1. Yes

    1. No
25. 2. Do you intend to use this animal for experimental or research purposes?

    1. Yes

    1. No

27. 3. Do you have a recent history (12 months) of abandoning your animal at Animal Control and Rescure or elsewhere?

    1. Yes

    1. No

29. 4. If you rent, does your lease allow for pets?

    1. Yes

    1. No

    1. I own

33. The following questions will assist our adoption counselors in helping to match you with the type of pet you are interested in adopting.

    The following questions will assist our adoption counselors in helping to match you with the type of pet you are interested in adopting.

35. 1. What type of pet are you here to adopt?

    1. Dog
    2. Cat

    1. Puppy

    1. Kitten

    1. Other

37. 2. What size of animal are you looking for?

    1. Toy/Small

    1. Medium

    1. Large

    1. Giant

39. 3. What best describes the pet you are looking for? Check all that apply

    1. Athletic/High Energy
    2. Outdoors
    3. Barn Cat

    1. Mellow
    2. Guard

    1. Family Pet
    2. Working

    1. Hunting
    2. Companion

41. 4. How many people live in your household?

43. Adults

44. Children

45. Please list children's ages

47. 5. Tell us about the pets you currently own. Please list animals species, name, age, breed, and whether they are spayed or neutered:

49. 6. How many pets have you had in the last five years?

51. Dogs

52. Cats

53. Other (please list type)

55. 7. Where will your pet spend most of the day? (Be specific: in house, crate, basement, garage, etc.)

57. 8. When your pet is outside, how will it be kept? (fenced yard, pen, etc.)

59. 9. How did you hear about this pet? (Petfinder, Shelter website, Facebook, etc.)

61. 10. Please tell us anything else you would like for us to consider.

65. Please initial that you understand the following:

67. I understand that long haired animals require routine grooming that be time consuming and expensive.

68. Your Initials*

70. I understand that animals require routine and preventative veterinary care.

71. Your Initials*

73. I understand that pursuant to City Code or Ordinance 5.33 I my animal must be provided with adequate care which means normal and prudent attention to the needs of an animal, including wholesome food, clean water, shelter, and health care as necessary to maintain good health in a specific species of animal.

74. Your Initials*

76. I understand that if this pet is for a minor, pursuant to City Code of Ordinance 5.32 the parent or guardian of a minor child is responsible for the adequate care of any animal owned by, in the control of or harbored by that minor child.

77. Your Initials*

81. By typing my name below, I certify that the information provided in this Application and attached documents is true and complete, and that any misrepresentation or omission made in this Application may result in the denial, suspension or revocation of any previously (or subsequently) approved application. I also understand that the St. Joseph Animal Control and Rescue reserves the right to refuse an adoption application.

83. Signature*

84. Date*

88. OFFICE USE ONLY

90. Approved

91. Declined

93. Adoption Counselor/Animal Care Specialist

94. Supervisor

96. Date Approved/Declined

97. Date Notified

99. Explanation

Leave This Blank:


100. 1. Receive an email copy of this form.
101. Email address

     This field is not part of the form submission.

102. Submit Submit and Print

* indicates a required field