Jersey Shore Animal Center, 185 Brick Blvd., Brick, NJ 08723

Phone (732) 920-1600, fax (732) 920-3706

DOG APPLICATION (internet)– please print and fill out completely

 

ANIMAL NAME__________________________2NDCHOICE_________________________

YOUR NAME______________________________________PHONE________________________________

ADDRESS_____________________________________TOWN____________________________ZIP________________

EMPLOYER____________________________________PHONE_____________________POSITION________________

 

PET INFORMATION :

Have you adopted from the JSAC before?    Y  or  N     If yes, when? _____________________ 

Do you have any pets currently?    DOGS    how many?________    CATS     how many _______ Other_____________________

Name of dog(s) ______________________________________________________________________________________

Breed of Dog(s)___________________________________________________Age(s)________________________

Name of cat(s)___________________________________________Age(s) _______________________

How many pets have you had in the last five years?  DOGS _____  CATS  ______ OTHER ______

Name and breed of dog(s)_____________________________________________________________________

Name of cat(s)________________________________________________________________________________

What happened to these pets?   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: ________________________________________________________________________________________________________

________________________________________________________________________________________________________

Are(were) all of your pets spayed or neutered?  Y  or  N   If no, please explain

                                                                                                                                                                                               

How often do your pets see the veterinarian?

                                                                                                                                                                                               

Name of vet _________________________________Address______________________________________phone______________

What last name is the pet listed under? ______________________________________________

HOME INFORMATION

# of adults in home_________  do all the adults work full time?  Y  or  N  

# of children in home __________ please list ages __________________________

If no children reside in home, do any visit frequently?   Y  or  N  

If yes, please list ages ____________________

Has anyone in the home experienced allergies to animals?  Y  or  N

Do you:     OWN    RENT   SHARE DWELLING   LIVE W/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?    Y   or   N

Do you plan to move within the next year?   Y   or    N

If you move, what will you do with the pet? ______________________________________________

Do you have a :    FENCED YARD    DOG HOUSE     DOG CABLE    DOG RUN   OTHER___________________

If fenced, how high?    ____________    What type of fencing?_______________________

If you have none of the above, how do you plan to exercise/toilet the dog? _______________________________________________________________________________________________________

LIVING ENVIRONMENT

Where will the dog spend most of the day?     INDOORS     OUTDOORS

If indoors:   CRATE     BASEMENT/GARAGE    FREE RUN OF HOUSE   LIMITED AREA OF HOUSE

Where will the dog be kept when nobody is home?   INDOORS     OUTDOORS

Where will the dog sleep at night?  INDOORS        OUTDOORS

If inside:    CRATE      DOG BED       BEDROOM     BASEMENT/GARAGE     FREE RUN

How many hours will the dog be left alone each day?  ____________________________

Who will be responsible for feeding, cleaning up after, exercising the dog? ___________________________________

Who will be responsible for veterinary bills? __________________________________________________________________

Have you ever house broken a dog before?   Y   or   N   

Taken an obedience class?    Y   or   N

Would you be willing to attend an obedience class with your new dog?     Y    or    N

What personal circumstances or dog behavior would cause you to give up your pet? ____________________________________________________________________________________________________

Are you interested in (please circle):    HOUSE PET      OUTSIDE PET        GUARD DOG   

WATCH DOG FOR BUSINESS            BREEDING              GIFT

If gift, for whom is the dog 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 DOG 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.