Reptile Adoption ApplicationPlease enable JavaScript in your browser to complete this form.Basic Information - Step 1 of 4Name *FirstLastAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Phone *Birth DateNames and ages of any additional people living in the house/Apt: *Is everyone in the house comfortable living with reptiles? *YesNoNames and ages of any other pets living in the house: *NextWhich reptile are you interested in adopting? Why are you interested in adopting this reptile? *Have you ever owned or have/had experience with reptiles before?YesNoWho will be primarily responsible for the reptiles’s care? Are you comfortable handling insects? *YesNoDo you plan to use this reptile for breeding purposes? *YesNoMaybeAre you willing to take on a reptile with special needs (one that requires hand feeding, help shedding, etc.)? *YesNoAre you currently employeed *NoYes, Full TimeYes, Part TimeYes, I work from homeWhat type of residence do you live in? *HouseCondoApartmentOtherPlease Explain "Other" Answer *Do you own or rent your residence? *OwnRentDoes your landlord or rental agreement allow for pets in the house? *YesNoDoes One Love have permission to contact your landlord? *YesNoLandlord Name and Phone Number *Please explain why we cannot contact your landlord? *PreviousNextDo you already have an enclosure for this reptile? *YesNoAre you willing to obtain one before adopting the animal? *YesNoUpon application approval, do you consent to allowing one of our team members to deliver the reptile to your home and review the enclosure set up? *YesNoWho will watch your reptile when you go out of town?What do you plan to do with your reptile if you decide to move?Under what circumstances would you not be able to keep this pet?What would you do with the pet if you determined you were unable to keep him/her? * What other pets have you owned in the last 5 years? What happened to these pets? *How do you plan to deal with unwanted behaviors your reptile may present (aggression, skittishness, etc.)?How much money are you prepared to spend annually on routine medical care for this pet (check-ups etc.)?PreviousNextUnder what circumstances would you be unable to provide medical care for this pet?What veterinarian do you plan to use for this pet? (If you don't know of a reptile Vet, please let us know so we can provide you information on multiple in the area)Would you be interested in fostering other reptiles in your home on a temporary basis?YesNoMaybe in the FutureIs there anything else you would like us to know? I agree that all information submitted on this application is true and accurate. I understand that if I adopt an animal from One Love, this form will become part of the adoption record. By submitting this application I consent to receiving emails from One Love Animal Rescue and am aware that I can unsubscribe to these emails at any time. *Today's Date: *MessageSubmit
