E-mail address: 

If you don't already have an e-mail address, we suggest going to www.yahoo.com or www.google.com and signing up for a free e-mail account.

If this is entered incorrectly, I will NOT be able to contact you to complete this application. Make SURE that you enter your correct e-mail address!! (E-mail addresses do not begin with “www”; AOL members, make SURE you put your entire e-mail down!)

Name:

Complete Address::
(Hint: Complete address means to include city, state and zip code)

(Yes, I get apps frequently without this info, and they get disregarded.)

Home Phone:

Work Phone:

Occupation:

Age: 

Have you read the sample adoption contract?   Please do so before filling this out. 

For which ONE specific species are you applying to adopt?:
  BE SPECIFIC - do not say "snakes" ; one application for each species is required

What kind of housing do you live in? (example: House, Apartment, Condo, Mobile home, with relatives, other 

If you rent, will your landlord object to your having a reptile? :

If you rent I may require a signed release from your landlord stating that you have permission to keep reptiles on the property.

How long have you lived at your present address?:

Are you planning to move in the next 6 months? If you move what would you do with the animal?:

Have you ever adopted an animal before?:

If you have adopted an animal before what is the current status of that animal?:

If you were forced to give up an adopted animal, what would you do with it?

Have you ever brought any of your own animals to a shelter or rescue society? If yes what were the circumstances?:

Have you owned or cared for reptiles or amphibians before? If so what kind?:

If you no longer have these animals, explain how long you had them, and what happened to them.

If you already have a veterinarian who is experienced in evaluating reptiles and amphibians,  please type their name
and phone number here:  

If your new animal gets lost what steps will you take to find it?

How much do you anticipate spending yearly to provide the appropriate food/ medical care,
 permits (if required in your area) and supplies?:

What types of supplies and food do you think you will need for the animal you wish to adopt?

What kind of housing do you think this animal requires at it's present size? what kind of housing will it need in one year? In five years?

How much do you think it will cost for you to acquire the necessary supplies and food for this animal?:

Do you intend to breed this animal?  If so what do you intend to do with the offspring, and are you willing to personally take back any offspring that the new owners cannot keep any longer?:

How many adults in your household?:

How many children in you household?:

What are the ages of the children?:

Do all family members favor getting this type of animal?:

Which members of your household will be primarily responsible for the feeding, cleaning, handling (if appropriate) and general care of this animal?

Please tell us what you already know or have learned about the needs and disposition of this species. (Please answer in general I realize many applicants will have extensive knowledge.)



Many reptiles live longer than 15 years; some tortoises may live more than 100 years. Are you ready to take responsibility for the animal you adopt for its entire life?

What provisions will you make to assure that care is given for this animal if the primary care giver dies or is no longer able to care for it?

What books or other materials have you read about the animal you wish to adopt?

What books relating to this animal, or to reptile or amphibian care do you presently own?

Do you belong to a herpetology society? If so which one(s)?


Green Iguana related questions. If you do not wish to adopt an Iguana, please skip the Iguana questions, and scroll down to after the green stars.

Have you ever kept an Iguana before?

If you have had an Iguana before what happened to it? ( be honest if it died - this is not necessarily a disqualifier given the poor information about iguanas that is out there.)


Are you prepared to provide suitable housing for an Iguana? This means at least a dedicated room or room-sized enclosure.

If you have not already done so, please read the Iguana Care, Feeding and Socialization article, and the Dealing with Breeding Aggression article, linked to the Iguana Care page located at www.anapsid.org to get some idea of proper care, housing, and behavioral issues. It is also a good idea to have either Iguanas for Dummies (Melissa Kaplan) on hand, or the Green Iguana Handbook (James Hatfield).

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If you are adopting a prey-eating animal, are you prepared to locate a source of pre-killed food? Do you have experience in using pre-killed food for reptiles? Explain briefly why pre-killed food is generally better than live food for prey-eating reptiles.

What other types of animals do you have?:

What will you do about care for your reptile or amphibian when you have to travel on business or vacations?

Please write down any other pertinent information you think will help me get to know you better as a prospective 'parent'.


Please list the names and contact information (phone and e-mail) of at least two people who have direct knowledge of your ability to care for the animals requested. VaRR will make every effort to contact them prior to approving any applicant. Applications without references may be discarded!!!

Reference contact 1:

Reference contact 2:

Reference contact 3:

By sending this form you are certifying that all answers to the above questions are true to the best of your knowledge. Anything which is found to be untrue, or which is left unanswered or partially answered may be cause for denying this application for adoption. Further, you certify that neither you nor any co-applicant, have ever been convicted of any crime relating to the abuse, cruelty, or neglect of another person or any animal.