Personal Information
Name:*
Address:*
PO Box (if applicable):
City:*
State:* Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming
Zip:*

Daytime Phone:*
Alternate Phone:
Email:*
Drivers License #:* State:* Exp. Date:*

Animal Adoption Information
What type of animal are you interested in adopting?*
Male Female Don't Care

Is there a specific animal you would like to adopt?
(Please note that many of the animals at the Sanctuary are permanent residents and cannot be adopted. If you have questions about the adoption status of a specific animal, please email us.)

What is your interest in this type of (or this specific) animal?*


How will you transport the animal you hope to adopt?*


If you were to move, what would you do with this animal?*


When you are out of town, what care will be provided for this animal?*


Current Animal Situation
Do you currently have other farm animals? If so, please note the number each.
Cows, steers, or bulls of any variety
Goats
Sheep
Emus
Chickens or other poultry
Ducks or other water birds
Llamas or aplacas
Horses or mules
Mini horses
Donkeys (burros)
Potbellied pigs
Farm pigs
Other

How long have you had the animals listed above?


Please describe your relationship with these animals:


If you no longer have one or more of the animals listed above, please explain:


Do you breed your animals, or have you bred in the past?*
Yes No
If yes, please explain:


Current Facilities
Describe the facilities you currently have for the type of animal you hope to adopt:*
Housing:

Fencing:

Pasture/Outdoor living area:


If you do not yet have facilities, do you need advice on the type of facilities appropriate for this animal?
Yes No

What past experience have you had with farm animals (or of any sort, not just the type you are interested in adopting?)*


Eating Habits
Are you:*
Vegetarian Vegan Neither
Please be honest. Note that answering "neither" will not prohibit you from adopting an animal.
If you are neither vegetarian nor vegan, please explain:


Zoning Information
Do you own or rent?*
Own Rent
If you rent, we will need to either see a copy of your lease indicating that the type of animal you wish to adopt is allowed or a signed letter from your landlord. Additionally, include your landlord's name and phone number below:
Landlord's name:
Landlord's phone number:

Do the zoning laws where you live allow the animal you hope to adopt?*
Yes No Don't know

Veterinary Information
Have you located a vet in your area that can treat the animal you hope to adopt?*
Yes No
If yes, record your veterinarian's information:
Veterinarian's Name/Hospital Affiliation:
Veterinarian's Phone:
Veterinarian's Email:
If no, do you need help locating a vet?
Yes No

Other Information
Please describe the members of your household not previously listed:
Children? Ages:
Adults?
Dogs?
Cats?
Other animals not listed above?


Are you currently involved in any of the following?
4H
Animal welfare or protection organizations
Animal rights organizations
If so, please describe your involvement:


References
At least two references from individuals unrelated to you are required.

Reference 1:
Name:*
Relationship:*
Phone:*
Email:*

Reference 2:
Name:*
Relationship:*
Phone:*
Email:*

Reference 3:
Name:
Relationship:
Phone:
Email:

*I understand that a home visit by a Ching Farm representative may be required before I can take my adopted animal home. Further, I authorize Ching Farm representatives to make unannounced home visits to check on my adopted animal.