2. Name (First, Last Name)*
4. Email*
6. Date of birth*
8. Home address *
10. City*
12. Zip code*
14. Phone #*
16. [Space]
18. Have you filled out a pre-adoption form?*

    1. No [If No, you will be asked to fill out a pre-adoption form]
    2. Yes
20. [Space]
22. What pet type are you interested in adopting? Please be specific to help us provide the best match for you.*

    1. Livestock
    2. Domestic Bird
    3. Guinea Pig
    4. Rabbit
    5. Ferrett
    6. Chicken
    7. Rooster
    8. Snake
    9. Lizard
    10. Other
24. If other, please specify.
26. Would you consider a pet that is special needs?*

    1. Yes
    2. No
28. Would you consider a pet that needs to be the only pet?*

    1. Yes
    2. No
30. Would you consider a pet that cannot be with young children?*

    1. Yes
    2. No
32. *If you consider any of these the shelter can help educate you on the above*
34. Which gender would you prefer?*

    1. Female
    2. Male
    3. Either
36. What age range are you looking for?*

    1. 2 months - 6 months
    2. 6 months - 1.5 years
    3. 1.5 years - 3 years
    4. 3+ years
    5. Senior
38. Is there any additional information we should know? (i.e. good with kids, etc)*
40. The staff of Tri-City tries their best to call our citizens with pet requests when the animals come in, however we are not always able to do so. It is best to still come in on your own and to keep an eye on our website, www.luvpets.org.
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