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

Phone (732) 920-1600, Fax (732) 920-3706 www.jerseyshoreanimalcenter.org

FERRET APPLICATION – Please print and fill out completely

ANIMAL NAME _________________ 2 ND CHOICE ________________ Staff/Volunteer _________

YOUR NAME ________________________________ PHONE ________________________________

ADDRESS _________________________________TOWN ________________________ ZIP ________

EMPLOYER ____________________________ PHONE ________________ POSITION ___________

PET INFORMATION

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

How many pets do you own currently? DOGS _______ CATS _______OTHER _________

Dog name(s)___________________________ Cat name(s) __________________________

Ferret name(s) _____________________________

How many pets have you had in the last five years? (NOT INCLUDING THE ABOVE PETS) DOGS ______ CATS _____FERRETS ___________OTHER ______

Dog name(s) ___________________________Cat name(s) __________________________

Ferret name(s) _____________________________________________________

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 new owner:

_______

Are (were) all of your pets spayed or neutered? Y or N

If not, please explain:

Who is your veterinarian?

Name ______________________________ Address ___________________________________

Town ________________________________State ________ 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? ______________________________________

FERRET QUESTIONNAIRE

Have you ever owned a ferret before? Yes or No

Would you like information on ferret care? Yes or No

Where will your ferret be housed? ________________________________________________

Do you plan to cage your ferret? __________________________________________________

What size cage do you have? _____________________________________________________

What type of flooring does the cage have? ___________________________________________

What type of bedding do you plan to use? ___________________________________________

What do you plan to feed your ferret? (Please be specific) ______________________________

Do you plan on brushing/bathing your ferret? Yes or No

Do you know how to clip your ferret’s toenails? Yes or No

Does your veterinarian treat ferrets? Yes or No

If not, would you like a recommendation on a vet who does treat ferrets? Yes or No

Do you plan on having children handle the ferret? Yes or No

If yes, what age are the children? _______________________

Have the children handled ferrets before? Yes or No

Are you interested in a HOUSE PET OUTSIDE PET SCHOOL PET GIFT

If gift, for whom is the ferret a gift? ______________________________________

I, THE UNDERSIGNED, HEREBY AUTHORIZE JSAC TO VERIFY THAT ALL 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 Relative Vet Phonebook Walk-In