FLASh
Friends of the Lafayette Animal Shelter

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone

Which pet are you interested in adopting?
Sorry, no animals found

Your Age*

Please list the names and ages of other people living in your home.*

How long have you lived there?*

How would you describe your home atmosphere most of the time?*
Choose one: Very busy, active Busy sometimes, quiet other times Quiet, not much activity

Type of home*
Choose one: Military Housing Own House Own Mobile Home Rent Apartment Rent House Rent Mobile Home

Please provide your landlord's full name and phone number, if renting.

Who is your veterinarian? Include past vet, if you've had pets in the past. (Full Name, City, and phone number)*

Where will your cat live?*
Choose one: Inside only Outside only Both

Do you have a screened-in porch?

Tell us about the pets you have now. Dog? Cat? Name? How long have you had them?

If you have a cat now, where does he/she live?
Choose one: Inside only Outside only Both

Are all of your present pets spayed/neutered?
Choose one: Yes No

Please tell us about your past pets. Please include dogs and cats, how long you had them, and what happened to them.

Please feel free to share anything else you'd like us to know.