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Sacred Earth Animal Rescue, inc
68107 CR 138, Grover, CO 80729 307-640-6703
PO Box 15708, Cheyenne, Wy 82003 (mailing)
Date: __________
Applicant Name: ___________________________________________________________
Phone Number(s): __________________________________________________________
Applicant Address: _________________________________________________________
(Street) (City) (State) (Zip)
Mailing Address (if different): _________________________________________________
(Street) (City) (State) (Zip)
Address that animal will be kept: _____________________________________________
(Street) (City) (State) (Zip)
Are you aware that there is an adoption fee for this animal? ___Yes ___No
Do you have the means to care for this animal? (i.e. funds, food, shelter) ___Yes ___No
Have you ever been convicted of animal cruelty, neglect, or abuse? ___Yes ___No
Describe where the animal will be kept (area and shelter): _______________________________________________________________________________
Are you aware of the type of food this animal requires? ___Yes ___No If you are unaware of the type of food, please let us know so that we can provide you with the information. There are also books on this subject.
Do you have experience in taking care of the kind of animal? ___Yes ___No If you are unaware on how to take care of this animal, please let us know so we can provide you with information. There are also books on this subject.
May Sacred Earth Animal Rescue, inc inspect the place where this animal will be kept?
___Yes ___No May we re-inspect in 6 months? ___Yes ___No
Do you understand that certain types of animals must be altered (spayed, neutered, gelded, etc.) before leaving the rescue? ___Yes ___No
Should you be unable to keep this animal, do you agree that the animal will be returned to us or allow us to assist in new placement of this animal? ___Yes ___No
What animal are you applying to adopt? _______________________________________
Do you have a way to transport this animal? ___________________________________
Please mail this application to: Sacred Earth Animal Rescue, PO Box 15708, Cheyenne, WY 82003 or email it to: SacredEarthRescue@live.com. If you have any questions before completing or sending the application, email us or call 307-640-6703.
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Applicant Signature
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Co-Applicant Signature