Jersey Shore
Animal Center, 185 Brick Blvd., Brick, NJ 08723
Phone
(732) 920-1600, Fax (732) 920-3706 www.jerseyshoreanimalcenter.org
BIRD APPLICATION - Please
print and fill out completely
ANIMAL NAME _________________ 2ND CHOICE ________________ Staff/Volunteer _________
YOUR NAME
________________________________ PHONE
________________________________
ADDRESS _________________________________TOWN
________________________ ZIP ________
EMPLOYER ____________________________ PHONE
________________ POSITION ____________
PET INFORMATION
Have you adopted from the JSAC before? Yes or No
If yes, when? ________________
How many pets do you own currently? DOGS _______ CATS _______ OTHER
_______
Dog name(s) _______________________ Cat name(s) _____________________________
Bird(s) _________________________ Other __________________________________
How many pets have you had in the past five years?
(NOT INCLUDING THE ABOVE PETS)
DOGS _________ CATS
_________ BIRDS _________ OTHER _________
If no longer owned, what happened to these
pets? Circle below
LOST STOLEN
GIVEN AWAY GIVEN TO
SHELTER SOLD DIED
STILL HAVE
If pet died, please list date and cause of
death
______________________________________
If given away, please explain circumstances and
indicate name and address of current owner:
______________________________________________________________________________
How often do your pets see the veterinarian?
__________________________________________
Name of vet ____________________Address
________________________ Phone __________
Under what LAST NAME is the pet listed
____________________________________________
HOME INFORMATION
#
OF ADULTS IN HOME ________ Do all the
adults work full time? Yes or No
#
Of children in home ________________
Please list ages _____________________________
If
no children reside in home, do any visit frequently? Yes or No
If
yes, please list ages ________________________
Has
anyone in the home experienced allergies to animals? Yes or No
**********
PLEASE FILL OUT OTHER SIDE ************
Do
you: OWN RENT SHARE
DWELLING LIVE WITH PARENTS OTHER ______
IF YOU RENT, YOU MUST PROVIDE JSAC WITH A COPY OF YOUR RENTAL AGREEMENT (EVEN IF YOU RENT FROM A RELATIVE)
LANDLORD
NAME: ________________________ PHONE
_____________________
Home
Type: HOUSE CONDO
APARTMENT TRAILER OTHER _____________
How
long at this address? ________________
Do
you agree to a house visit by JSAC prior to adoption? Yes or No
Do
you plan to move within the next year? Yes or No
If
you move, what will you do with the pet? ______________________________________
BIRD QUESTIONNAIRE
Have you ever owned a bird before? Yes or No
If yes, what type? __________________
Where will your bird be housed? INSIDE ______OUTSIDE _____ BOTH _______
What sort of housing would you provide for the bird?
________________________________
___________________________________________________________________________
What size cage do you have? __________ Does it have
a wire mesh floor Yes or No
What do you plan to feed your bird? (Please be specific)
_____________________________
What will you provide for your bird to gnaw on?
____________________________________
Do you plan on bathing your bird? Yes
or No
Does your veterinarian treat birds? Yes
or No
If not, would you like a recommendation? Yes
or No
Do you plan on having children handle the bird? Yes or
No
If yes, what age are the children?
_______________________
Have the children handled birds before? Yes or No
Are you interested in a HOUSE PET OUTSIDE PET SCHOOL PET GIFT
If gift, for whom is the bird a gift?
______________________________________
I, THE UNDERSIGNED, HEREBY
AUTHORIZE JSAC TO VERIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT, AND
PERMIT THE RELEASE OF VETERINARY HISTORY
Sign
here __________________________________________ Date ___________________
How
did you hear about us? Petsmart Internet Friend Vet Walk-In Relative TV
PLEASE BE ADVISED: The JSAC adoption process may take several days. Applying for a pet does not guarantee approval or adoption or place a hold on an animal. Decisions are made in the best interest of the animals and people involved.
THANK YOU for coming to the Jersey Shore Animal Center. We hope you had a nice visit.
What happens now?
It will take us 24-48 hours to review your application. We strive to place the right animal in the right home. Your patience and understanding is appreciated. There may be other applications submitted on the same animal. When there are equally qualified candidates for an animal, we must go by date of the application.
Please call us at (732) 920-1600 to follow up on the status of your application. If you are approved and the animal is ready, we will schedule a time for you to take the animal home. Below are our adoption fees.
If you have placed a “general” application, please tell us what you are seeking. If you are approved and an animal with the breed/age/size comes in that you are seeking, we will call you. We also recommend that you visit frequently since new animals come to us daily. You may also visit our website http:/www.jerseyshoreanimalcenter.org to see photos and descriptions of the animals available. The site is updated weekly.
Adoption fees*:
Dogs $100.00
Cats $ 45.00
Puppies $ 75.00 + $50.00 refundable spay/neuter deposit
Kittens $ 30.00 + $50.00 refundable spay/neuter deposit
Rabbits $ 35.00
All adult animals will be spayed or neutered prior to adoption (included in the adoption fee). We give routine vaccinations to our animals, as well as preventatives – all of this information will be supplied to you on the adoption paperwork. We will also provide you with a packet of information to take home and we are always glad to answer questions. WE ARE NOW MICROCHIPPING ALL DOGS, CATS, PUPPIES AND KITTENS. Please ask a staff member for more information.
*Payment can be made by cash,
Visa, Master Card and Discover. Please bring a driver’s license with
you as well as a leash and collar for dogs, or a carrier for cats to transport
them home. We recommend that you transport newly adopted animals separately
from other pets.