Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Describe your living situation
*
Please Select all that apply
Occupation
*
Please also list your hours
Please List Three References
*
Name, Phone #, Relation to you
Are you over 21?
*
Yes
No
Do you have children or are children over frequently?
*
Yes
No
If so, what are their ages?
*
Please list your veterinarian or veterinarians you have seen in the last 3 year
*
Name, Phone #, Address
Please List your other pets
*
Name, Age, Species
Sex
Male
Female
No preference
Does anyone in the household have allergies
*
If So, Who and to what species
Have you ever owned a rat before?
*
If So, How many rats have your owned in the past?
*
1-3
3-5
5-10
>10
Do you currently own any rats?
*
Yes
No
Who will be the primary caregiver for the rat?
*
Adult
Teenager
Child
Do you have a cage?
*
Yes
No
Size and description of enclosure
*
What room or area will the rat cage be in?
*
If you have other pets, have they lived with a rat before?
*
Yes
No
If so, how did they get along?
*
Are you preparted to keep your rat for the span of their life?
*
Yes
No
Rats should be on a specific diet for them are you willing to fed their diet?
*
Yes
No
Are you willing to take your rat to regular vet check ups?
*
Yes
No
How much time will you have to pay and interact with the rat?
*
Can you commit to caring for this animal its whole life?
*
Yes
No
If anything changes/ doesn't work out / or your health, will you guarantee that you will return the animal to our facility?
*
Yes
No
Will you be willing to commit to a two week trail period before finalizing the adoption?
*
Yes
No
