Home Departments Animal Shelter Animal Adoption Application
Animal Adoption Application

Please fill out the following information clearly and honestly..

Date: (*)

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Animal you are interested in: (*)

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Full Name: (*)

Please type your full name.
Home Phone: (*)

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Cell Phone:

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E-mail: (*)

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Address: (*)

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City, State, Zip: (*)

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Employer: (*)

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Number of adults in the household including yourself: (*)

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Number of children in the household including yourself: (*)

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Is everyone in the household in agreement about adopting a new pet? (*)

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Does anyone in your household have any known allergies to animals? (*)

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How long have you been at the above address? (*)

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Are you planning to move in the near future? (*)

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Please check all that apply: (*)

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If you rent you need a lease stating that animals are allowed before being considered.

Landlord Name:

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Landlord Phone:

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Are animals permitted?

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Do you have a lease stating animals are permitted? (*)

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For the Dogs:

Do you have a fenced yard? (*)

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Fence Type:

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Fence Height:

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How will you exercise the dog? Where? How often?

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Have you had animals in the PAST? If yes please list breeds.

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Please list animals you CURRENTLY have including breed, sex, age, neutered/spayed, and if they are current on vaccinations.

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Your CURRENT or PAST Vet Information.
If you have never owned a pet before and therefore did not have a vet, please disregard this section.

Vet Name:

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Vet Phone:

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Vet Address:

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Vet City/State/Zip:

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Name the vet records are under?

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Last Vet visit?

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A dog/cat can live up to 20 years. Are you prepared and willing to give the medical treatment it needs for it's life span? (*)

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Do you agree to have this animal spayed/neutered if it is not already? (*)

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Are you prepared to bring your pet for its yearly exam and vaccinations? (*)

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Where will this animal you adopt spend most of its time? (Check all that apply)

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How long will the animal you adopt be left alone during the day? (*)

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Are you willing and able to attend training classes if needed? (*)

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Do you understand that bringing an animal home you must be patient and allow time for the animal to adjust to its new house/routine? (This may include house breaking accidents, chewing, barking, whining or hiding) (*)

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Have you ever relinquished or given up an animal? If yes please explain: (*)

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