School House Rescue
Note: The term "School House Rescue" refers to the animal adoption program run by the Animal Science class at Broome-Tioga BOCES. Also, applications submitted during school vacation periods may not be received until school resumes.
This application may also be printed and filled in manually and mailed to the above address. If you wish to submit the application in this manner, please click on the Printable Adoption Application and follow the instructions.
We know this application may seem lengthy but it really does help us evaluate whether or not the animal you are applying to adopt is a good match for your family and lifestyle. The more detail you provide, the more help we can give you in selecting a pet that you will enjoy for the rest of its life.
The BOCES Animal Science class does ask for an adoption fee in order to help cover expenses for the animals in our care.
Instructions: Please answer all applicable questions on the application. Use the TAB key to move from field to field.
Caution: If you hit the Enter key, the application may submit before you have completed it. When you have completed the application, click on the Submit button once at the bottom of the page.
This application must be completed by a responsible adult who is over 18 years of age.
Name:
Address:
City:
State:
Zip:
Home phone:
Cell phone:
If you rent, please provide a copy of the rental agreement which allows pets and the name and phone number of landlord.
Landlords name:
How long have you lived at this address?
If less than one year, please provide previous address:
Please list the animal(s) that you are interested in adopting:
Why have you chosen this pet?
Describe, in your opinion, what you want this dog/cat to be...i.e., your perfect pet:
Since we all know that no pets are perfect, what habits or characteristics are the LEAST acceptable, i.e., the behaviors that you absolutely cannot live with or will cause the pet to lose its home:
Where will the pet spend the day?
Where will the pet spend the night?
On average, how many hours will the pet spend without human companionship?
If you are adopting a dog:
Do you have a completely fenced yard?
If so, how high is the fence?
What type of fence is it?
If your yard is not completely fenced in, how will you exercise the dog and provide adequate time for bathroom breaks?
If you are adopting a cat:
Will the cat use a litter box or go outside for bathroom breaks?
If the cat will be using a litter box, where will you put the box ? On what floor and room of the house?
The following information will help us determine which pet is right for you by determining how much experience you have with the type of animal you are hoping to adopt.
Do you currently own cats?
If yes, please list them below including name, sex,breed, age, spay/neuter, vaccination dates and description.
Do you currently own dogs?
If yes, please list them below including name, sex, breed, age, DOG LICENSE TAG NUMBER, spay/neuter, vaccination dates and description.
Do you currently own any other types of animals (e.g., pocket pets, farm animals, exotic pets)?
If you do, please list them. If they have a veterinarian other than the one listed below as a reference, please provide the name and phone number for this veterinarian.
Please list all of these pets and provide the following information: Name of pet, breed, age and year of death or rehoming, veterinarian who would have spay/neuter and vaccination records. If the veterinarian is other than the one listed below as a reference, please provide the name and phone number for this veterinarian. If we have provided insufficient space below, attach a separate piece of paper with the information.
Note: If your pets have received vaccinations at clinics that will not show up in regular veterinary records, please either fax or mail a copy of the certificates. This will help us determine whether you have maintained up to date vaccinations regularly.
Veterinary Reference:
Name:
Address:
City:
State:
Zip:
Phone Number:
Please call your veterinarian and give them permission to release records to Rescue. This will speed up the approval process. Also when providing veterinary information we need ANY veterinarian that has seen your pet.
Personal References: (may not be a relative)
Personal Reference #1:
Name:
Address:
City:
State:
Zip:
Phone:
How long have you known this person?
Have they ever visited your home?
Personal References: (may not be a relative) Personal Reference #2:
Name:
Address:
City:
State:
Zip:
Phone:
How long have you known this person?
Have they ever visited your home?
Personal References: (may not be a relative) Personal Reference #3:
Name:
Address:
City:
State:
Zip:
Phone:
How long have you known this person?
Have they ever visited your home?
Number of adults living in your household:
Number of children living in your household?
Age and sex of each child:
Do you have regular visitors to your home? Yes or no, Explain:
Do you understand and agree that any pet adopted from this facility must be cared for in a responsible way, which includes spay/neuter, vaccinations according to veterinary guidelines and regular worming?
Do you understand and agree that any pet adopted from this facility will be kept under control at all times and not allowed to run at large?
Do you understand and agree that, if, for any reason, you cannot keep any animal adopted from this facility, you MUST notify this facility to allow us the option to request return of the animal?
All of the above information which I have provided is true and complete.
Should an unneutered or unspayed dog or cat be placed with me, I agree to have it neutered or spayed by such date agreed to by me and an Animal Science representative. At that time I will forward proof of spay/neuter to the Animal Science class. I understand that under certain circumstances there will be a spay/neuter refund which will be discussed and arranged for at the time of adoption.
This pet will reside IN my home. I will provide it with quality food, water, shelter, training, affection and medical care.
I understand that BOCES Animal Science is a referral service and is not responsible for the accuracy of the information received about the habits, temperament or physical condition of the animal available for adoption.
I understand that it is my responsibility to evaluate the pet for myself before agreeing to adopt it.
I am in full agreement with the terms of this adoption.
BOCES shall not be liable for, and is hereby relieved from, all liability for any damage, expenses, causes or action, fines, suits, demands, judgments or claims of any nature whatsoever arising from or by reason of any damage to property or injury to any persons caused in whole or in part by the pet placed in your home.
I hereby accept and assume such liability and agree to protect, indemnify, and hold BOCES harmless from and against all of the aforesaid.
Submitting this form constitutes your permission for us to check references.
WE RESERVE THE RIGHT, IN OUR SOLE DISCRETION, TO REFUSE ANY APPLICANT FOR ANY REASON WHATSOEVER, PRIOR TO RELEASE OF OWNERSHIP OF THE ANIMAL TO ITS NEW HOME.
Applicant signature:
(Applicant must be 18 years or older)