Adoption Application

Contact Information

Name*

First Last

Address*

Street Address County City State ZIP Code

Primary Phone*

Email*

Experience

How many years of experience do you have with reptiles?*

Which types of reptiles do you have experience with?*

Have you ever had to rehome an animal?*

Yes

No

Please explain why this animal was rehomed.*

Exotic Vet Information

Do you have an exotic vet?*

Yes

No

Exotic Vet Name*

Exotic Vet Location*

Exotic Vet Phone*

Household Information

Do you own or rent?*

Own

Rent

Does your landlord allow animals?*

Yes

No

How many adults are in your home?*

How many children are in your home?*

How many animals are in your care?*

Please list the animals in your home.*

Have any of your pets been sick within the last 3 months?*

Yes

No

Please describe your pet(s) illnesses and veterinary care received.*

Your Next Pet

Which animal(s) are you interested in adopting?*

How many hours per week will you dedicate to this animal's care?*

Where do you purchase your feeders?*

Do you need recommendations on where to purchase feeders?*

Yes

No

Do you have the proper equipment ready to adopt this animal?*

Yes

No

Please list this equipment.*

Please provide a picture if your enclosure and equipment.*

Multiple images of all of your equipment is preferred.

Drop files here or

Max. file size: 512 MB.

One Last Step

By providing your signature below, you indicate that you agree with the following statement: "I declare and confirm that all the information provided in this form is true, accurate, and complete to the best of my knowledge. I understand that providing false or misleading information may have legal consequences and can result in the termination of any agreements or arrangements made based on this information."

Signature*

Your name as signed*