Use the Tab Key to advance from field to field
ALL FIELDS ARE REQUIRED. ENTER NONE OR N/A IF NOT APPLICABLE.
Name of Pet Applying for:
Do you or have you owned pets?	Select One First Time Pet Owner Had pets in the past, as Child Had pets in the past, as Adult Currently Own Pet(s)
General Information
Applicant Name
Spouse or Significant Other's Name
Address
City, State, Zip
Home Phone
Cell Phone
Work Phone
Email Address:
Drivers License Number
How many adults live in your household (other than those listed above)?
How many children live in your household?
If you have children, what are their ages?
Does anyone in your household have allergies to animals?	Select One Yes No
Do all the adults in your household know that you plan to adopt a new pet?	Select One Yes No
Housing Information
What type of home do you live in?	Select One House Townhouse/Condo Duplex/Tripex Apartment Mobile Home
Do you own or rent your home?	Select One Own Rent Live with Parents
If you rent, please provide your landlord information	Name:   Phone:
How long have you lived in your current residence?
Do you have plans to move within the next six months?	Select One Yes No
If YES, what are your plans for your pet(s) when you move?
What is the general household atmosphere?	Select One Busy/Fast Pace Some Activity Quiet
Pet Ownership Information
What type of pet are you looking for?	Select One Indoor Cat Outdoor Cat Indoor and Outdoor Other (explain) If other, explain:
Who will be the adopted pet's primary caretaker?
How often do you travel?
How will your adopted pet be cared for while you are away on travel/vacation?
How many hours during the day will your adopted pet be left alone?
Are you aware of the annual routine vaccinations recommended for the health and protection of your intended adopted pet?	Select One Yes No, please tell me more
If you currently own any pets, are all your pets up to date with their vaccinations?	Select One Yes No Don't Know N/A-Don't own any pets
Are you prepared to assume the financial responsibility of providing your adopted pet with adequate food, medical care, housing, training, toys, etc.? ($500.00+ per year)	Select One Yes No
Are you prepared to commit to caring for your new adopted pet for the next 10 to 15 years?	Select One Yes No
Change is inevitable in one's lifetime.  What will you do if you move or can no longer care for your adopted pet?
Pet History (Previous 5 Years)
Please provide information for all the pets you have owned (or currently own) within the past 5 years.

Pet #1	Pet #2	Pet #3	Pet #4
Type:	Type:	Type:	Type:
Breed:	Breed:	Breed:	Breed:
Age:	Age:	Age:	Age:
Sex: Select One Male Female	Sex: Select One Male Female	Sex: Select One Male Female	Sex: Select One Male Female
Spayed/Neutered: Select One Yes No	Spayed/Neutered: Select One Yes No	Spayed/Neutered: Select One Yes No	Spayed/Neutered: Select One Yes No
Declawed: Select One Yes No Not Applicable	Declawed: Select One Yes No Not Applicable	Declawed: Select One Yes No Not Applicable	Declawed: Select One Yes No Not Applicable
Where Kept: Select One Indoor Outdoor Indoor/Outdoor	Where Kept: Select One Indoor Outdoor Indoor/Outdoor	Where Kept: Select One Indoor Outdoor Indoor/Outdoor	Where Kept: Select One Indoor Outdoor Indoor/Outdoor
Vaccinated: Select One Yes No	Vaccinated: Select One Yes No	Vaccinated: Select One Yes No	Vaccinated: Select One Yes No
Years Owned:	Years Owned:	Years Owned:	Years Owned:
Still Owned: Select One Yes No	Still Owned: Select One Yes No	Still Owned: Select One Yes No	Still Owned: Select One Yes No
If no, where is pet now?	If no, where is pet now?	If no, where is pet now?	If no, where is pet now?

Name and Phone of your Vet and/or Clinic	Name: Phone:
Name account (with vet) is listed under:
Have you ever brought an animal to a shelter or humane shelter?	Select One Yes No
Have you been convicted of or received citations for the violation of Federal, State, or Municipal animal codes?	Select One Yes No

By submitting this application to Gulf Shore Animal League, I certify that I am at least 21 years of age and the information I have provided is true. I recognize that any misrepresentation of facts may result in my losing the privilege of adopting a pet. I authorize any and all verifications of statements made in the application, and I understand that the Gulf Shore Animal League has the right to deny my application. I agree to hold GSAL and Alley Cat Rescue harmless for any issues related to this pet’s health and/or temperament. I further understand that I am not purchasing a pet, but adopting a homeless animal. Any donation made on this pet’s behalf is not tender for this pet and is non-refundable. Donations to GSAL are applied 100% to approved programs, services, and operations. Registration number CH15717.