Name:  First    M.    Last

Age   D/O/B   Occupation:

Address  City  State   Zip

Phone Number    E-mail

Animal(s) your interested in applying for, in order of preference:  

#1

#2

#3

Please provide the names and contact information (phone number & e-mail addresses) of AT LEAST 2 references that can attest to your ability to care for a new animal:

Where did you find out about our website and adoption service?:

Please answer all of the following questions honestly. This is not only for us to view you as a new prospective parent, but also to allow you to evaluate yourself and whether or not you are ready for the commitment to provide a permanent home to a new animal. 

1.       Do you live in a:

House Apartment_condo Mobile home With parents or relatives dorm other

2.    If you rent, will your landlord object to your having this particular type of animal? (Note: failure to disclose that you have a reptile may result in your being evicted.)

Yes No I don't know

3.       How long have you lived at your present address?

4.       Are you planning to move in the next 6 months? 

Yes No

* If you move, what are you planning to do with your animal?

5.       Have you adopted an animal before? 

Yes No

* If yes, what kind of animal, and what is the current status of that animal?

6.       If you must give up this animal, what do you plan to do?

7.       Have you ever brought any of your own animals to a shelter or rescue society?

Yes No

 * If yes, what were the circumstances:

8.       Have you owned or cared for the same type of animal (s) you wish to adopt before? 

Yes No

* If yes, what kind (species name) and how many?:

9.       If you no longer have these animals, please explain how long you had them and why you no longer have them:

10.       Do you already have a veterinarian who is experienced in evaluating and treating the type of animals your applying for? 

Yes No

* If yes, please give the name and phone number:

* Are you financial prepared to deal with an unexpected illness or injury to your new animal?

Yes No

11.       If your new animal gets lost, what steps will you take to find it?

12.       How much do you anticipate spending annually to provide the appropriate food, medical care, permits (if required in your area) and supplies (please specify how much you anticipate spending on what items)?

13.       What types of caging, supplies, accessories, and food do you think you will need NOW for the animal you wish to adopt (please specify sizes and amounts where appropriate)?

* How about in 5 years?

14.       Please describe the cage and supplies you already have set-up for this animal (Note: we may require photos).

* How much do you think it will cost for you to acquire additional supplies and food not already in your possession?

15.       How many adults in your household?

* Number of Children?

* How old are the children?

16.       Do all family members favor getting this type of animal?

Yes No Haven't asked

* If no, please explain (this is not necessarily grounds for denial):

17.       Which member(s) of your household will be primarily responsible for the feeding, cleaning, handling (if appropriate) and general care of this animal?

18.       Please tell us what you already know or have learned about the needs and disposition of the of animal your applying for?

* Do you intend to breed this animal (not necessarily grounds for for denial. Some would make valuable contributions to the gene pool)?

Yes No

* If yes, what do you intend to do with the offspring?

19.       Many animals can live a long time, many in excess of 15 years ex: some tortoises may live more than 100 years. Are you ready to take responsibility for the animal you adopt for its entire life?

Yes No

* What provisions will you make to assure it is taken care of after you or the primary care-giver dies or is no longer able to care for it?

20.       What books or other materials have you read about the animal you wish to adopt? What books relating to this animal(s), do you presently own?

21.       Do you belong to any animal clubs or groups directly associated with the animal (s) you wish to adopt? Ex; Herpetological society for reptiles, Avian society for birds, etc...

Yes No

* If yes, which one(s):

22.       Answer these questions if you want to adopt an iguana (if not, just mark N/A and move on to 23):

* Have you ever kept any before?

N/A Yes No

* If so, what happened to them? (Be honest if it died - this is not necessarily a disqualifier given the poor information out there.)

* Are you prepared to provide suitable housing for one? 

N/A Yes No

* What would you consider suitable housing for an adult iguana?

·         If you have not already done so, please read Melissa Kaplan's Iguana Care, Feeding and Socialization and Dealing with Breeding Aggression articles, linked to her Iguana Care page to get some idea of proper care, housing, and behavioral issues. And you may want to take a look at the Iguana Teeth page and illustrations.

23.       What other types of animals do you have?

24.       What will you do about care for your animal (s) when you have to travel on business or vacations?

25.       Please put down any other pertinent information you think will help me get to know you better as a prospective 'parent.'