Dog Adoption Application

Please fill out this form completely if you are interested in adopting an animal from the Kalamazoo Animal Rescue.

If your browser has problems with this form, send us an email and be sure to provide contact information. You should receive a response to your application with in the next few days.

You must be 18 years or older to complete this application.

You may need to travel to the foster home in the southwest Michigan area to meet the animal you are interested in.
Please Note: All dogs are located in loving foster homes and not at the shelter. Your adoption counselor will work with you and the foster home to arrange a meet & greet.

Dog of Interest This application is being filled out for

Titus

who is being fostered by

BValade

If there are any additional animals that you are interested in,
please put their name(s) and their foster parent(s) name here:

Applicant Information Your First Name: (Required)
Your Last Name: (Required)
Age (Required)
If under 21, please provide parent's or guardian's name and phone number
Address - Please Note: We do not ship animals. (Required)
City (Required)
State (Required)
Zip (Required)
Home Phone
Work Phone
Cell Phone
What is the best time and method to contact you by?
Email Address (Required)
(please enter carefully as we cannot respond to mistyped email addresses)

Ignore this. If you enter anything, the form will not be sent.:

Your Occupation
Spouse/Partner/Roommates's Occupation
If student, where do you attend?

*A visit to your home with the dog is required

Housing Information Do you live in a: (Required)
House Apartment Condo Mobile Home
Do you own or rent? (Required)
Own Rent

If you rent, you must supply your landlord's name, phone number, and the name of apartment complex: (Required)

* If you rent, you must confirm with your landlord that you are allowed to have this breed of dog before filling out this application.

How long have you been at this address?
If you are not the homeowner (for example, living with parents), please provide the homeowner's name and phone # (Required)
Do you have a fenced-in yard (i.e. chain link, electric, kennel area, privacy, other)?
*The dog you are applying for may require a physically fenced in yard.

Vet Information What Veterinarian/Clinic do you use?Please include veterinarian/clinic name along with city and/or phone number. (Required)
What kind of heart worm prevention, if any, do you use? (Required)
Do you use flea prevention? Yes No
Are your dogs current with vaccines? (Required) Yes No
Are your dogs licensed and micro-chipped? Licensed Micro-chipped Both
Submitting an application for adoption constitutes agreement to verifying your current pet's or past pet's reproductive status and health with the vet on this form. Check the box to acknowledge this requirement. I agree (Required)
Please notify your vet within 24-48 hours that you have submitted an application to adopt and they may release information to KAR. Failure to do so can result in significant delays.

Reference Information How did you hear about the Kalamazoo Animal Rescue?
Have you ever applied for a Dog or contacted the Kalamazoo Animal Rescue before? Yes No

Additional Comments Any Additional Comments:

By checking this box, you affirm that all of the above information is complete and correct.