List ALL the people currently living in your household (including yourself):
List all pets currently in the household AND ALL PREVIOUS pets within the past 5 years:
Total hours per day pet will be left alone:
I understand that TPAS can deny an adoption if this application contains any false or misleading information. By submitting this form, I am giving my consent for my veterinarian to release all information regarding all of my animals (past and/or present) to TPAS, its employees, and/or agents. I hereby accept the terms of the TPAS adoption agreement. Completion of this application does not guarantee that I will be allowed to adopt. Shelter Staff reserves the right to refuse adoption to anyone.