Farm Animal Adoption Form CONTACT INFO * Your Name * Your Email * Street Address * City * State ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming * Zip Code * Phone Number * Phone Type HomeMobileWork * Alternative Phone Number * Phone Type HomeMobileWork HOUSEHOLD INFO * Are you over 18 ---YesNo * Do you own or rent a home ---OwnRent * If you rent, please tell us your landlords name and phone number ADOPTION INFO Potbellied pigs & other farm animal pets are considered to be livestock in most states, so please check the current laws in your area to see if you are zoned to keep a pig or farm animal at your home or facility. * Are potbellied pigs considered to be livestock where you live? ---YesNo If yes, are you zoned for livestock where you live? ---YesNo * Please tell us why you would like to adopt a pig or other farm animal pet from Pets Alive: * Do you agree to care for the farm animal pet for the rest of his/her life? ---YesNo * Are you willing to have a Pets Alive staff person or member representative do a property and facility check? ---YesNo * If you adopt a farm animal pet from Pets Alive, do you have any purpose in mind for the animal, other than as a pet (for example, a 4-H project)? ---YesNo If yes, please explain * Will this be your first farm animal pet? ---YesNo * Please briefly describe your past experience with farm animal pets * If you have had farm animal pets in the past, please tell us what they were used for and why you do not have them now: OTHER PETS *Do you currently have other pets that are considered livestock? ---YesNo If yes, please list the type of animal, age and how long you've had the animal * Do you currently have other pets? ---YesNo If yes, please list the type of animal, age and how long you've had the animal * Are all your current pets spayed or neutered? ---YesNo * Are your current pets up to date on all vaccinations? ---YesNo CARING FOR THE FARM ANIMAL PET * What will you feed your farm animal pet? * How often will you deworm the farm animal pet? * If the pet is to be a companion for another animal, tell us about that other animal: * Tell us what types of vaccinations a farm animal pet should receive in your area, and how often: * Who will be responsible for caring for this farm animal? * Please describe how the farm animal or pig will be housed * If a pig, will the pig live in your house or outdoors? If the pig lives outdoors, will s/he have shelter? ---YesNo * If the pet will live outdoors, is there heat in the pet's house for winter? ---YesNo * Is there adequate shade for summer? ---YesNo * Is there room for a pool and/or wallow? ---YesNo * What type of fencing do you have? * Please provide us with your veterinarian's information: (Name, Address, Phone) * Please provide two references, people not related to you, who can testify to your ability to provide and care for a farm animal pet:: (Name, Address, Phone) * How did you hear about Pets Alive?
