First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone*
Cell Phone
Alt Email
Your Date of Birth: MM / DD / YYYY*
Which animal are you interested in Choose an animal: Alisha Angus Arissa Avita Baybee Bubba Bubbles Buddy Burton Cappuccino Caramel Carolina Catori Chanel Chauncey Chelsea Chessie Chuckie Cleopatra Cordie Crush Cuca Cuff Cyrus Dapple Darryl Derry Donavan Donnie Eliza Elmer Emlyn Enrique Evan Folie Franklin Fred Freddie Garfunkle Gideon Grayson Honey Bear Houston Isabella Isabelle Jorge Joshua Juan Kaiden Lazlo Leo Leslie Madeline Maizy Mickayla Mike Milli Miranda Miri Misha Mister Motu Mr. Big Stuff Mystery Nike Pandora Percy Phil Pico Ping Pluto Racha Rachelle Rafael Reesa Reesa Rocky Rosslyn Rosslyn Sammy Scaredits Scootie Scrappy Serephina Shena Shergar Shortcake Sir Ups-Alot Sombra Speedy Squirt Squirt Squirtle Squirtle Sugar Suki Taylor Tazu Thundershell Tickles Tinka Tizzy Tizzy Toby Tommy Turtleclese Typhoon Vance Wayzz White Shadow Willace Wilson Xera Zlatan
If unknown, do you have a species, sex or age preference?
Why are you interested in adopting a pet at this time*
Do you currently keep any reptiles? If so, what species do you keep and how long have you been keeping it or them?*
Describe in detail your setup for the "Adopted" Animal(s). Please include details about lighting, heating, dimensions, and decor. We ask that you email a picture of your finished setup to adoptions@littleresq.net*
If you need help building a setup for your adoptive pet, what is the budget you have set aside? We will do our best to help you out. *
What other types of pet(s) are in your household?*
Do you own or rent your home* Choose one: Rent Own
If you rent, have you received the approval of your landlord to have an animal* Choose one: Yes No
Who in the household will care for the pet*
Veterinarian's Name and Phone Number*
Have you ever given up a pet? If yes, please explain*
I certify that the information entered on this applicant is true. Enter your name and date*
Parental Signature is required if the applicant is under 18 years of age.