Please enter your full legal name
Your Date of Birth
Name of pet you would like to adopt
Would you like to adopt a second rabbit (littermate/bonded pair)?
Name of second pet
Betty (Cat - 2019515)
Bo & Pima (Cat - 2021014)
Cheshire (Cat - 2017242)
Copper (Cat - 2017130)
Gus (Cat - 2019010)
Holly (Cat - 2020111)
Jean 1 (Cat - 2018385)
Kaitlyn (Cat - 2019136)
Missy (Cat - 2020576)
Mr. Orange (Cat - 2020626)
Nikki (Cat - 2021004)
Oliver Twist (Cat - 2020439)
Prada (Cat - 2020036)
Rocky II (Cat - 2019529)
Sophia Marie (Cat - 2020642)
Stephanie (Cat - 2019544)
Tammy (Cat - 2019247)
Twilight Sparkle (Cat - 2014061)
Please enter at least one phone number below
Co-applicant for this Adoption (if any)
Is there a co-applicant ?
Your relationship to the Co-Applicant
Tell Us About Your Home
Do you live in a:
Do you own or rent your home ?
Landlord's Phone Number
Landlord's Email Address
Landlord's Mailing Address
About Your Household
HUMAN Household Members
List HUMAN household members, ages, pet responsibilities
Who would be the primary care giver?
Do all adults work outside of the home full time?
Is anyone in your home allergic to pets?
Are you or anyone in the household a smoker?
Does everyone in your home know that you are interested in bringing a rabbit into the home?
Please describe your home life (active, quiet, hours spent at home)
ANIMAL Household Members
Please list your ANIMAL household members (Age, breed, sex, spayed/neutered, and date of rabies vaccination). Please include any that have passed within the last 12 months.
Are your current pets spayed and neutered?
How many pets have you owned previously?
Why do you want to adopt a rabbit?
Companion for me
Companion for another pet
Have you had a rabbit in the past?
Do you still have this rabbit? If not, please explain why.
If this rabbit is being adopted as a companion for a current rabbit, tell us about your rabbit's personality:
If this rabbit is being adopted as a companion for a current rabbit, is the current rabbit spayed or neutered?
Approximately how many hours a day will you spend with your rabbit?
How and where do you plan to house your new rabbit?
If you have other animal companions, please describe how they would interact with your new rabbit.
Are you willing to let a SNAP representative come for a home visit before or after adoption?
Yes, with notice
Do you have a veterinarian who looks after your animals?
Your veterinarian's name
Your veterinarian's phone
May we call your vet to confirm your pets are altered and vaccinated?
Can you please provide us with two personal references?
Name and phone or email for first reference
Name and phone or email for second reference
What else should be know?