Farm Animal Adoption Application Blue Barn Rescue Farm Animal Adoption Application Thank you for your decision to adopt a rescued small animal. You are encouraged to look at all the animals available to find one that is best suited to your lifestyle. Blue Barn Farm & Sanctuary reserves the right to accept or deny any applicant or application based on our requirements for adoption and the needs of the small animal being applied for. Completion of the application does not guarantee approval. Any false information provided by the applicant will result in a nullification of your application and contract. You must be 23 or older to fill out this application; NO EXCEPTIONS. **This is NOT the Adoption Contract. Please answer EVERY applicable question. If this application is incomplete, you will receive an error message. Your answers will help us make sure we have the perfect match** Name * First Name Last Name Applicant DOB/ Age * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * (###) ### #### Please check the type of pet you are interested in adopting: * Chicken Duck Mini horse Goat Sheep Other Please name the pet(s) you are interested in adopting * We recommend you list several pets in case your first choice is not available What specific requirements are you looking for in your pet? * ** If we do not have the pet you are currently looking for, we may be able to find a pet that is suitable for you ** Please specify WHY and WHY NOW you are interested in this/these pets... * How did you hear about us? * Internet Facebook Instagram Another rescue Word of mouth Freind/ Family Employer * Work Phone * (###) ### #### Are you currently a student? * Yes No My Current Residence is: * House Apartment Condo/Townhouse Mobile Home Farm Do you: * If other, Please explain Own Rent Live with parents Other How long have you lived at the above address? * If less than one year, please give previous address and how long: If you rent, please complete the following: Landlord Phone (###) ### #### Are pets allowed? Yes No Is a pet deposit required? Yes No If yes, has the deposit been paid? (Will be verified) Yes No How many household members? * NAMES and AGES of ALL adults over the age of 18 living in your household: * AGES of ALL children under 18 living in your household: Name of current vet you intend to use: * Vet phone number: * (###) ### #### Will the pet reside with you at your current residence? (if not, please explain) * If YES, Is your residence zoned for the type of pet you want to adopt? Yes No Are there any town ordinances that may interfere with the type of pet you want to adopt? Yes No If yes, please explain: How many acres do you have? If NO, where will your pet be living? Please explain: Facility name: Facility address Address 1 Address 2 City State/Province Zip/Postal Code Country Facility contact name First Name Last Name Contact phone number (###) ### #### Who will have financial responsibility for providing necessary veterinary care? * If not yourself, please provide name and phone number of financially responsible party: Who will be responsible for the daily care and feeding? * Are you aware of the food and vet care needed for your pet? * Yes No Are you aware of the lifespan of the pet you are adopting? * Yes No Have you considered budgeting for your pet's expenses such as: food, bedding, grooming, outerwear, pet sitters, boarding, annual veterinary care, emergency or urgent care and other unexpected health expenses that can incur? Please explain * Why are you adopting this pet? * Gift for another family member or friend Companion for self/family For breeding purposes For food purposes Other If other, please explain Have you ever owned any pets/ farm animals? * Yes No If no, please list reason: Do you currently own any pets/ farm animals? * Yes No If yes, please list breed, sex and age of all pets: If you have owned pets in the past that are no longer with you, please explain what happened to them: Have you ever adopted from a shelter/rescue? Yes No Was it a positive experience? Yes No Have you ever taken an animal to a shelter? If yes, please explain: Are your current pets: Indoor Indoor/outdoor Outdoor only Where do you plan to keep this pet? * Inside Outside Inside and Outside Are your current pets spayed or neutered? Yes No Do you plan to spay/neuter this pet? * Yes No If you move, what do you plan to do with this pet? * If you become ill and incapacitated, what do plan to do with this pet? * Do all members of your household want this pet? * Yes No If NO, please list who is not in favor, and why: Are you prepared for common pet behavior problems, such as skittishness, nipping, etc...? * Yes No If NO, please list what you are not prepared to deal with: **Please note that most of our pets come from high kill shelters. Many times we do not have background information on these pets, or any other medical history than what is provided, and what our own vets can tell us. While we work extensively on behavior and temperament, we do not “temperament” test. This is why we will ALWAYS take our pets back if it does not work out, in fact, that is a requirement.** * Applicant please initial that you have read and understand the above: Veterinary Reference: Veterinarian Name First Name Last Name Veterinary Pratice: Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Email If you do not currently have a veterinarian, where do you anticipate taking your pet for care? Please Explain: Personal References: Name First Name Last Name Phone (###) ### #### Relationship (not in household) Name First Name Last Name Phone (###) ### #### Relationship (not in household) The information submitted on my application above and on previous page is true and correct to the best of my knowledge. I understand that by signing this application, I agree to the liability waiver terms in the event that I visit Blue Barn Rescue as part of the adoption process. * Applicant's Signature Date * MM DD YYYY Please attach photos of your pet’s living environment in a separate email to mary@bluebarnrescue.org. If you do not have the environment set up yet, you can add these at a later date. **Application approval is subject to approval of living environment. You must send photos BEFORE adoption can be finalized** Thank you for submitting your application! We will review your application and someone will get back to you within 24-48 hours. To view our liability waiver terms, click HERE.
