Adoption Application for Small Animals

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Thank you for your interest in adopting from the Surrey Animal Resource Centre. If you have any questions or concerns about any part of this form, please let us know! Adopters must be over 19 years old. We reserve the right to refuse this application.

Date*

Animal Name:*

Animal #:*

Animal Type:*

Guinea Pig
Gerbil

Hamster
Rat

Chinchilla
Ferret

Small Bird
Large Parrot

Reptile
Other:

Contact Information

First Name:*

Last Name:*

Unit # / Address:*

City:*

Province:*

Postal Code*

Phone Number:*

Email:*

About Me

How long have you been thinking of welcoming a new pet into your home?*

Have you ever surrendered a pet to a shelter or other organization in the past?*

Yes
No

Please indicate reasons:

About My Home

Number of adults in the household?*

Number of children?*

Ages?

What kinds of animals live in your home?*

None
Cats
Dogs
Other:

For whom are you adopting this animal?*

Who will be the primary care giver?*

Do you live in a:*

House
Townhouse
Apartment
Trailer
Condo
Other - please specify:

Do you own or rent?*

Own
Rent

Do you have landlord's permission to keep a pet?*

Yes
No

Landlords Name (First & Last):*

Phone #:*

How long have you lived at this address?*

Information we collect and why we collect it.

Personal information is collected for the purpose of adopting an animal. The City of Surrey is collecting this information under s. 26 (c) of the Freedom of Information and Protection of Privacy Act. For questions regarding the collection of personal information, please contact the Surrey Animal Resource Centre Manager, 17944 Colebrook Road Surrey, 604-574-6625.

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