Luna's House, Inc. Adoption Application

If you are considering adopting a pet from Luna's House, please take the time to fill out this application. By filling out the application, you allow us to match the perfect animal(s) for your family and household. Filling out the application is not a commitment to adopt.

**You MUST fill out this application completely. Partially filled out applications will NOT be accepted**

If for some reason you have technical problems with this form, please let us know.

Name(s) of animal(s) you are interested 
in (if applicable):
Please list your Full name (First, Middle Initial, Last).
Please list the Full name (First, Middle Initial, Last) of any other adults in your household.
Are you at least 21 years of age? Please note that we can only accept applications from individuals who are at least 21 years of age Yes No
Please enter your date of birth.
Address:
City, State and ZIP:
Telephone:
Email  address (PLEASE BE ACCURATE, this is how we will contact you):
What type of home do you have?
Do you (select all that apply)

Own Rent living w/roommates Rent living alone

Living with Parents Student Other

If renting, Landlord's Name and Phone
How long have you been at your current address?
Is everyone in the household aware of your decision to adopt an animal? Yes No
If not, list their name(s)
Does any member of your household have any known allergies to animals? Yes No
If yes, please describe:
How many children are in your home? Please list the ages of any children.
What is your occupation? What is your spouse's occupation?
If you were to move from your current address, what would your plans be for the animal(s) you adopt?
What is your experience with the type of animal before? Have never been the guardian for this type of animal before
Have had 1-2 Have had several
Have you adopted from Luna's House, Inc. in the past? Yes No
If yes, do you still have the pet? Yes No
If you no longer have your pet please explain why?:
Please state your reason for wanting to add the animal you wish to adopt to your household
Where will the animal you adopt be residing? Inside Outside Both
Please describe where you intend to keep the enclosure for the animal(s) you adopt. Please provide the dimensions and/or the make and model of the cage you plan to provide for your new animal(s). Please include the type of flooring/shelving your enclosure has (wire mesh, solid plastic, wood, etc.): (Suitable housing can be recommended)
Who will take primary responsibility for the animal you wish to adopt?
What food(s) will you provide for the animal(s) you adopt? Please include the brand of pelleted food you intend to use, if applicable.
What type of bedding/litter do you intend to use for the animal(s) you adopt? Please include the brand of the bedding/litter you intend to use, if applicable
Do you know how to introduce the new animal to other animals living in your home? Yes No
Are you willing to work through any unforeseen behavioral problems you may encounter with your new animal? Yes No
If no, why not?
Have you ever surrendered an animal to a shelter? Yes No
If yes, what were the circumstances?
If living with parents, what would your plans be for the animal(s) you adopt when you move out?
Please describe all animals currently living in your home (including housemates' animals). For each animal, please list species/breed, age, sex, whether they are spayed/neutered, where (s)he is kept, and how long you have had him/her.
Please describe all previous animals you had in the last ten years (those who are no longer in your care). For each animal, please list species/breed, age, sex, whether they are spayed/neutered, where (s)he is kept, and how long you had him/her.
Do you smoke inside your house? Yes No
Are your pet's vaccinations and medical examinations up-to-date? Yes No
What vet hospital(s) do you use for your current animals and will you use for the animal(s) you adopt?
(An experienced veterinarian for the type of animal you are adopting can be recommended)
Luna's House requires small animal adopters to take their adopted animal(s) in to see a licensed veterinarian within 7-10 days of adoption for a general wellness exam; once a year for an annual exam (once every other year for birds and reptiles); and in the event of injury or illness. Are you willing to provide this veterinary care for the animal(s) you adopt? Yes No
Do you have any additional questions for the Small Animal Adoption Team?
Thank you so much for submitting your application to adopt (an) animal(s) from Luna's House! Please click submit when you have completed your application: