Small Scale Reptile Rescue

Online application Coming Soon.

Thank you for your interest in adopting one of our pets. After you have completed the application, please expect 48 hours before you get a reply.

ALL ADOPTIONS AND FOSTER HOMES WILL BE FINALIZED THROUGH A LEGALLY BINDING CONTRACT.

ATTENTION: IF YOU DO NOT HEAR FROM A VOLUNTEER WITHIN 48 HOURS, PLEASE EMAIL us AS YOUR APPLICATION MAY BE LOST IN CYBERSPACE!

* = required

*Today's Date:
*Name or species of animal you are interested in adopting:

*Your Full Legal Name:
*Date of Birth:
Spouse (Roommate) Name:
Date of Birth:
*Address (Line 1):
Address (Line 2):
*City:
*State:
*Zip Code:
*County:

*E-mail Address:
*Home Phone:	Please include the area code.
Cell Phone:	Please include the area code.
*Who do you live with?
Ages:

How many adults in the household?

How many children in the household?

Please provide the gender and ages of the children:

*Do you rent or own?
Accommodation type:
If you rent, do you have your landlord's permission to keep a reptile?
Can you provide a copy of your lease?

Landlord's Name:
Phone Number:	Please include the area code.

*How long have you lived at this address?

If under 2 years, please give your previous address:
Address (Line 1):
Address (Line 2):
City:
State:
Zip Code:
County:

*Do you have suitable caging prepared for the pet you are looking at now?

*Are you prepared for full adult sized caging for the pet you are looking at?

Please describe the current caging you have available. Type, height and approximate size.

*Please briefly describe the cage needed for this species of animal.

*Please briefly describe the diet needed for this species of animal.

*Who will be responsible for the care of this animal?

*Why adopt this species?

*Is the animal for your family or a gift for someone else?

If the animal is a gift, please explain further.

*Does the entire family want this pet?

If answering no, please explain who and why not:

*Do you know of any laws in your area that involve reptiles?
*Do you have other reptiles? Please give details.

*Any other animals? Please give details.

Please provide the details of your regular veteranarian:
*Name:
*Address:
*Phone Number:	Please include the area code.


*Are you prepared for possible breeding season aggression, occasional times of handling issues related to shedding or other possible aggression issues?

*It may take several months for your new pet to adjust to it's new home. How will you handle this?
*Are you willing to commit to owning a reptile for the next 20-30 years if not longer depending on the species you are adopting?
*How did you hear about Small Scale Reptile Rescue?
Please provide 2 family members who will know your whereabouts for the next 5 years.
*Name #1:
*Address:
*Phone:	Please include the area code.
*Relationship:
*Name #2:
*Address:
*Phone:	Please include the area code.
*Relationship:
Please provide the names of 2 character references.
*Name #1:
*Address:
*Phone:	Please include the area code.
*Relationship:

*Name #2:
*Address:
*Phone:	Please include the area code.
*Relationship:
Is there any other information you would like to add? Please use the text field below.
*The information gathered on this questionnaire will be kept confidential. I certify that all information provided is complete and correct to the best of my knowledge.