First Name*

Last Name*

Email*

Application For:
Choose an animal: Downstream Goji Heidi Hope Jasper Maddie Mary Oliver (Ollie) Olivia Phoebe Soldier Sugar

OR Application For Preapproval*

Street Address*

City*

State*

Zip Code*

Cell Phone Number*

Home Phone Number (Optional)

Are you 21 years of age or older?*

Is your ENTIRE household on board for adoption? *

Please list the name AND age of EVERYONE currently living in your household (please include yourself):*

Are there children living in your household under the age of five?*

Have you, or anyone listed as living in the household ever been investigated for crimes involving an animal, including abuse and neglect? *

Does anyone listed as living in the household smoke inside the home?*

What type of housing do you live in?*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent the place you live? *
Choose one: Rent Own

If you rent, does your landlord allow pets? *

Have you received permission from your landlord? *

Landlord’s Name

Landlord’s Phone Number

Who is the adopted cat for?*
Choose one: Myself Family Children Gift

Will the cat be kept inside or outside?*
Choose one: Inside Only Outside Only Inside and Outside

Who will be the primary caregiver of the cat?*

What brand of food do you intend to feed the cat?*

Do you plan to declaw this cat?*

How do you feel about declawing?*

Do you have an in-home daycare?*

What would happen to your adopted cat if you were to move?*

Do you currently own any pets? *

If yes, please list each pet's name, breed, age, and where they are kept/housed (inside or outside):

Have all the pets listed above been spayed or neutered?

Are all of the pets listed above current on vaccinations (Rabies & Distemper at minimum)?

If ALL of your current pets are NOT spayed or neutered and current on vaccinations, why not?

Have you owned any pets in the past five years that are no longer in your possession? *

If yes, please list the breed, sex, age, and reason they are no longer with your family.

If you own dogs, have they been exposed to cats?*

What routine medical treatments/preventives do you consider necessary for this cat?*

How much would you expect to spend annually on medical care for a healthy cat?*

Are you prepared financially for annual and emergency care? *

Veterinarian information is required for all applicants. If you have never owned a companion animal, please list the information for the veterinarian you intend on using for your adopted cat.

Name of Veterinarian:*

Name of Practice:*

Phone Number:*

Have you seen this veterinarian before? *

What name is your vet account under?

Please list three personal references that we could speak to (two of the three references must be non-family). Please provide full name, phone number, and relationship for each reference:*

Under what circumstances would you surrender your dog? Have you ever needed to surrender a pet in the past? If so, explain. (*We require all dogs to come back to SFCR if you cannot keep in the future. We expect our adopters to make lifelong commitments when pursuing an adoption)*

How did you hear about us?*

I understand that submitting this application to Sioux Falls Canine Rescue is not a guarantee of acceptance, and that approval is contingent on many factors including an in-person or virtual home visit completed by a representative of Sioux Falls Canine Rescue. By singing this application, I certify that all the information I have provided is true and correct. I give permission to Sioux Falls Canine Rescue to check my veterinarian and landlord references.

E-Signature:*