Western New York Herpetological Society Adoption Application

Name:

E-mail:

Street Address:

Street Address:

City:

State: ZIP code:

Phone:

Are you 18 years of age or older?
Yes No

What kind of reptiles or amphibians are you looking to adopt?

Do you live in a:
House Apartment/Condo Mobile Home
With parents or relatives Dorm Room Other

If you rent, will your landlord object to your having a reptile? (Note: failure to disclose that you have a reptile may result in eviction.)
Yes No Don't Know

How long have you lived at your present address?

Are you planning to move in the next 6 months?
Yes No

If you move, what are you planning to do with your animal(s)?

Have you adopted an animal before?
Yes No

If yes, what is the current status of that animal?

If you must give up this animal, what do you plan to do?

Have you ever brought any of your own animals to a shelter or rescue society?
Yes No

If yes, what were the circumstances?

Have you owned or cared for reptiles or amphibians before?
Yes No

If yes, what kind (species name)?

If you no longer have these animals, please explain how long you had them and why you no longer have them.

Do you already have a veterinarian who is experienced in evaluating and treating reptiles and amphibians?
Yes No

If yes, please give the name and phone number:

If your new animal gets lost, what steps will you take to find it?

How much do you anticipate spending yearly to provide the appropriate food, medical care, permits (if required in your area) and supplies?

What types of supplies and food do you think you will need for the animal you wish to adopt?

How much do you think it will cost for you to acquire the necessary supplies and food?

How many adults in your household? Number of Children? How old are the children?

Do all family members favor getting this type of animal?
Yes No

Which member(s) of your household will be primarily responsible for the feeding, cleaning, handling (if appropriate) and general care of this animal?

If you are interested in adopting a particular species or type of reptile or amphibian, please tell us what you already know or have learned about the needs and disposition of this type of animal?

Many reptiles live longer than 15 years; some tortoises may live more than 100 years. Are you ready to take responsibility for the animal you adopt for its entire life? What provisions will you make to assure it is taken care of after you or the primary care giver dies or is no longer able to care for it?

What books or other materials have you read about the animal you wish to adopt? What books relating to this animal(s), or to reptile or amphibian care do you presently own?

Do you belong to a herpetology society?
Yes No

If yes, which one(s)?

What other types of animals do you have?

Please put down any other pertinent information you think will help us get to know you better as a prospective "parent."

The following questions are for those wishing to adopt iguanas.

Have you ever had an iguana before?
Yes No

If so, what happened to it? (Be honest if it died - this is not necessarily a disqualifier given the poor information out there.)

Briefly describe the enclosure the iguana will be housed in.