"*" indicates required fields CommentsThis field is for validation purposes and should be left unchanged.Date* MM slash DD slash YYYY Pet you are applying for*Name*Spouse/Partner's NameAge of Applicant*PhoneEmail Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country 1. Are you over 18 years of age?* Yes No 2. Please list the number of people and age that currently live in your household*AdultsAgeChildrenAge3. Are other members of your household in agreement with the adoption?* Yes No 4. Who are you adopting this pet for?* Yourself Someone else If someone else, please explain:5. Why do you want this pet?*Veterinary Care Information1. Can you afford regular veterinary care for the new pet which may range from $200-$300 a year?* Yes No 2. Can you afford to provide emergency care if the animal gets injured or becomes ill? This may range from several hundred to several thousand dollars.* Yes No 3. For dogs and cats: Do you currently use flea and tick/ heartworm prevention for your cat/dog? And what kind?*Regular veterinarians name and number: *OWNER MUST SUBMIT ALL CURRENT PETS VACCINE RECORDS* PET HISTORY (CURRENT-LAST 5 YEARS)*Pet NameType of PetMale/FemaleAgeSpayed/NeuteredStatus Add RemoveHousing1. How long will the pet be left alone and where will the animal stay while alone?* ALL SPARKY FUND ANIMALS ARE INDOOR ANIMALS ONLY!!! 2. Where will the new pet sleep?*3. Is your yard fenced?*4. What kind of home do you reside in? (House, apartment, condo or other)* If renting please include a copy of the lease agreement that states pets are allowed and that there are no breed or size restrictions. Also contact info for your landlord. Upload copy of lease agreementMax. file size: 768 MB. Landlord's NameLandlord's Phone #5. Is anyone in the home allergic to pets?*BEHAVIOR1. Do you plan on doing obedience training with your new dog?*2. What behavior methods will you use to deter destructive behavior?*3. If you move in the future, what will you do with the pet?*4. What are some behaviors you will not tolerate and if these behaviors come up what will you do to correct them?*