BRIGHT EYES SANCTUARY

& Rabbit Rescue

ADOPTION REQUEST FORM

 Applications must be filled out by an ADULT and filled out COMPLETELY.
All fields REQUIRED.

LOCAL ADOPTIONS ONLY.
That means Maryland, Virginia, DC, and parts of WV and Penn. If you aren't sure if you're in our adoption area, please inquire.

***PARENTS*** If you have children under the age of 8,
Read THIS before filling out this form!

Our application process enables us to process your request in a very timely manner.

Rabbit Name:
Applicant's FULL Name:
Address:
Apartment or Suite:
City:
State:	Please Select State AL AK AS AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY
Zip:
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Please describe living circumstances. Do You:	Own Rent Live with Roommates Rent, Live Alone Live with Parents Student Other (Please describe below)
If Other, please explain:
List all human members of household and ages of children:
May we schedule a home evaluation?	Yes No (Please describe below)
If not, explain:
Do you care for other pets right now? If so, please describe all including all animals in the household.  Include NAME, type, age, where kept and how long they have been in the household.
Exotic Veterinarian reference (name & phone):
Please tell us about all pets owned for the last decade that are not listed above. Include species, age, alter status, and how the animal came to be parted from you.
Please indicate which are reasons for which you might be forced to give up a companion rabbit. Please check at least one. Incomplete applications will not be processed.
Allergies:
Financial:
Overwhelmed:
Children Not Interested:
Baby Arrival:
Moving:
Doctor Request:
Cannot provide attention/lack of time management ability:
Unable to Care For:
Health Reasons:
Health Reasons Described:
Please tell us what is appealing to you about rabbits and why you are seeking one as a companion:
Please describe EXACTLY AND IN DETAIL how you will house and care for the pet rabbit:
How do you intend for your rabbit to exercise?
How did you hear about us?
May we contact you about volunteering?	Yes No