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P.O. Box 72040
Newport, Kentucky 41072
(859)391-1234
SAAP@fuse.net

Small Animal Adoption Application 


What type of pocket pet are you interested in?

Personal Information: 
Name:
Address:
Street
City    State Zip Home Phone: Cell: Alt: Email: Age Do you rent or own your home? If you rent, we will need to contact your landlord to verify that you are
allowed to have a pet on the premises.
Landlord Name: Phone: Questionaire: 
Have you ever given up a pet?
If yes, why and where did you take it? Have you ever been issued a citation for your pet or had to reclaim your pet from animal control/shelter? If yes please explain. Are there children in the home? If so, what are their ages? List any previous and current pets you have including their sex, age, current health condition or cause of death and if they were/are
spayed or neutered.

Will your new pet be kept inside, outside, or inside/outside? Do you have a cage? If you have a cage what size and type is it? Where will the pet stay if you go on vacation? If you have to move, what would you do with your adopted pet? Can you financially afford the Veterinarian costs for your new pet? Your current Vet and phone number: Please list at least 2 references:
Other Information or comments:

We accept cash or check only for Adoption fees. Thank you.


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