THIS NEEDS TO BE ONLINE FORM
*Required fields
Date: XXXXXX
Full Name: * text field
House / Building / Apartment Number: * text field
Contact Numbers: text field
#1 * #2
1. What type of animal are you interested in adopting?*
Dog / Cat / Other (check boxes)
Animal Name (if known or chosen already): text field
2. How long have you lived at the above address: * text field
3. Do you rent or own?
Rent Own Home (check boxes)
4. If you are renting please answer the following:
Landlord: text field
Contact #: text field
5. Who lives at this address?* text field
6. If there are any children living there what are their ages? text field
7. Does anyone who lives at this address have any animal allergies?
Yes No (check boxes)
8. What is the reason(s) for adopting the animal? text field
9. Who will be the caregiver for this animal? * text field
10. Are you planning on moving in the future? Yes No (check boxes)
If Yes will your pet be going with you? (check boxes)
Yes No
11. If you go out of town will you take your pet with you or will the pet stay at home?
Will travel with us / Will stay in Iqaluit (check boxes)
12. If your pet stays who will take care of them? (Please include contact information) text field
13. Will the animal be indoors or outdoors? Indoors / Outdoors (check boxes)
14. Have you ever surrendered an animal to the Iqaluit Humane Society?
Yes No (check boxes)
If Yes please explain: text field
15. Have you ever had an animal picked up by the By-law (check boxes)
Yes No
If Yes please explain: text field
16. Do you have any other animals living at your home? (check boxes)
Yes No
If Yes what are they and how old? text field
17. Are your pets spayed or neutered? Yes No (check boxes)
18. Will you be getting your new pet spayed or neutered? (check boxes)
Yes No
*Spayed means removal of female reproductive organs (ovaries).
*Neutered means removal of male reproductive organs (testicles)
If your vet is located outside of Iqaluit, NU proof of spay or neuter must be provided upon return to Iqaluit.
**All animals adopted from the Iqaluit Humane Society must have the spay/neuter procedure done on the next veterinarian visit to Iqaluit. Please read the Spay and Neuter agreement below that must be signed and agreed to as a condition of adoption.**
19. Would you be willing to let the IHS do visits to your home to check up on how the animal is doing? Yes / No (check boxes)
20. If you checked No to question 19 please state a reason why? text field