Adoption Application Form

Fill out the online form below if you are interested in one of our animals. Or if you prefer, you can print and mail your application in.
Dog Application (PDF) | Cat Application (PDF) | Other Animal (PDF)

First Name

Last Name

Your email

Your Address

Phone

Place of Employment

Adoption Questionnaire

NAME OF ANIMAL that you are interested in *

(See our Available Animals page for animals we currently have up for adoption. Please note that we only accept applications on animals that are adoptable and specified on your application. All other generic applications will be voided. NECCOG also does not hold applications. A new application will have to be submitted with each animal you are interested in.)

Type of animal *

Do you currently live in a *
HouseApartmentCondoOther

Please Specify:

Do you currently __________ the residence where you live? *
OwnRentLease

How long have you lived at your current residence?

Landlord's Name *

If you are not the property owner, NECCOG Animal Services will verify your residence's current pet policy.

Landlord's Phone Number *

How many adults live in your home?

Does anyone in your household have allergies?

Noise/activity level in my home is usually:

Who will be primarily responsible for the care of this pet?

Is this pet a gift?

How many hours will the animal be alone each day? *

How many hours will the animal be alone each night? *

Where will the animal be kept at night?

Where will the animal be kept when no one is home?

I would enjoy brushing or grooming my pet:

Do you have other pets? *

Do you have a regular veterinarian? *

Veterinary Practice Name *

Veterinarian Phone Number

Under what circumstances would you not keep this pet?

Pet History

Please list all the pets you have owned in the last 5 years including current pets, and those you no longer own.

Pet Name:

Species:

Breed

Age

Sex
MaleFemale

Altered?
YESNO

What happened to him or her?

Cat Questionnaire

My ideal cat would be:

Bad cat habits I just can't tolerate are:

Will this cat be:
IndoorOutdoorBoth

Would you declaw a cat?
YESNO

I certify that the above information is true to the best of my knowledge. I also acknowledge falsification of the above can result in being denied adoption of an animal or, if an animal has been adopted to me, the return of that animal to NECCOG animal shelter.

Signed: *

Date *

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