Forget Me Not Animal Shelter
PO Box 602
 
Republic WA 99166
 
(509) 775-2308


Please read the application FAQ before filling this out.

Adoption Application

Basic information

Applicant
 
Co-applicant
(if different)
Name
Mailing address
Physical address
(if different)
City, State, ZIP
Home phone
Cell phone
Email
Age
Employer
Work phone
  May we contact your employer to verify employment?
 

Household information

Other people in the household

Name Age
Continue in the comments box at the end if needed.

Animals you currently own

Name Species Breed Age Gender Altered?
Continue in the comments box at the end if needed.

Animals you have owned in the past

Name Species Breed Reason for loss
Continue in the comments box at the end if needed.

Adoption information

Which types of animals are you interested in?








Are you applying for a particular animal listed on our website?
lease specify:


What qualities and characteristics do you desire in your new pet?

About your home

Please describe your residence:

This residence is:

The pet will live: (select all that apply)



lease attach below, email to , or fax to (509) 779-4339 a copy of the pet clause of your lease or other written permission, along with contact information for your landlord or managing agent.


Is the yard fenced?
Please describe the height and type of fencing, or if no fence, how you plan to exercise and confine the pet:



When outside, the pet will be:



Where will the pet sleep at night?


Approximately how many hours per week will the pet be left without human companionship? Will the pet be indoors or outdoors when alone? What other pets will be with this pet?

References

Veterinarian
If you do not have a current vet, a past vet is fine; if this is your first pet, please tell us what vet you plan to use.
Name
Address
Phone
Personal Reference
If there is anyone who is particularly familiar with your pets and your pet care who would like to act as a reference for you, please list them here.
Name
Address
Phone

Attachments

Attachments are not currently working.
For now, please send attachments via email to .
If you live outside the Republic/Curlew area, please send photos of your home.

Comments