ADOPTION APPLICATION Adoption Application Please provide the following information to submit an adoption application with the Miramichi SPCA. What kind of animal are you applying for to adopt?(Required) Cat Dog Other Your Name(Required) First Last Today's Date(Required) DD slash MM slash YYYY Are you at least 19 years of age?(Required) Yes No Address Line 1(Required) Street Address Address Line 2 City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code How long have you lived at this address?(Required) Phone Number(Required)Email(Required) Name of animal you wish to adopt (if known) For whom are you adopting this animal?(Required) How many adults live in your household(Required)1-23-55+What are their ages?(Required) How many children live in your household?(Required)01-23-55+What are their ages?(Required) Are any family members allergic to cats?(Required)NoYesUnknownAre they severe allergies?(Required)YesNoUnknownAre any family members allergic to dogs?(Required)NoYesUnknownAre they severe allergies?(Required)YesNoUnknownWhy would you like to adopt this dog?(Required) Companion Guard Sport/Hunting Obedience Other Other(Required)Please explain. How would you describe your home(Required) Busy Not busy Loud Quiet Rowdy Calm Will this cat be(Required) Indoor only Outdoor only Indoor/Outdoor How will you contain the cat outside?(Required) Leash Secure area Free to roam Are you planning any big changes (holidays, moving, etc.) soon?(Required) Moving Holiday Change in schedule None of the above How busy is your street?(Required) Very busy Moderately busy Not busy Where will this animal stay during personal vacations?(Required) At home with care At the home of family or friends Boarding facility Other Other(Required)Please explain. Where will the dog spend the day?(Required) Loose indoors Loose outdoors Tied outside Fenced yard Kennel run Crate Basement Garage Other Other(Required)Please explain Where will the dog spend the night?(Required) Loose indoors Loose outdoors Tied outside Fenced yard Kennel run Crate Basement Garage Other Other(Required)Please explain Do you have a fenced yard?(Required) Yes No Fence height(Required) How many hours a day will the dog spend alone?1-45-89-1212+Are you willing and able to give the dog regular exercise?(Required) Yes No How will you handle the dog's exercise and toilet needs?(Required) Do you have a veterinarian?(Required) Yes No Clinic Name(Required) Can we contact them regarding the care of your pets?(Required) Yes No Do you rent or own your home?(Required) Rent Own Live with family Do you have your landlord's permission to own a pet?(Required) Yes No Landlord's Name(Required) Landlord's phone number(Required) Will you be having this cat declawed?(Required) Yes No Do you agree to have this cat spayed/neutered if not already done at the time of adoption?(Required) Yes No Do you own any other pets?(Required) Yes No List(Required)Use the "+" to add more animalsNameAnimalBreedSexAgeAltered?From where? Add RemoveHave you had other animals before?(Required) Yes No If they are no longer with you, what happened to them?(Required) Under which conditions would you return this animal?(Required) Agression/behaviour Scratching furniture Allergies Litter box problems Illness/disease Doesn't get along with others Too expensive No time Moving Family health/relationship stress New baby New pet Retirement Other None of the above Other(Required)Please explain Have you surrendered a pet to the SPCA in the past?(Required) Yes No Please explain(Required)What brought you to the Miramichi SPCA?(Required) Website Social Media Newspaper AdoptAPet.com PerFinder.com Google search Friend/Family Other Other(Required)Please explain PhoneThis field is for validation purposes and should be left unchanged.