Adoption Application

Thank you for choosing to adopt from the Animal Care Society. This is a general application for pre-approval for adopting from our shelter. All applications are subject to review by the Adoption Committee. Completion of this application does NOT guarantee an adoption. We accept multiple applications for individual animals. All items marked with an asterisk must be provided. Please enter NA to items that may not pertain to your situation.

Step 1 of 5

Pet's Name*
Your Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Cell Phone*
Other Phone
Emergency Contact For Microchip (Someone other than yourself)*

If adopting a dog, are there any other dogs (other than your own) that this dog must get along with? (Relative's dogs, dog sitter's dogs, neighbor's dogs)*
- Yes
- No
What training methods will you use to handle potential behavior problems like barking, chewing, scratching, house training, going outside the litter box, etc.?*
Please describe what personality of pet you are looking for? (energetic, loving, couch potato, etc.)*

Please list 2 personal references. Name, relationship, and phone#*
Although I understand that every animal adopted has been inspected and its history reviewed, I appreciate that you can make no warranty in regard to the pet and that you can give only such information as you have received with regard to the pet. I shall be personally responsible for the humane care and control of the pet. I further understand that any donation I have given to the Animal CCare Society is a donation towards its work in caring for the pets.*
- I agree to Certification terms and conditions listed above.
- I CANNOT abide by the Certification terms and conditions listed above.
Although I understand that every animal adopted has been inspected and its history reviewed, I appreciate that you can make no warranty in regard to the pet and that you can give me only such information as you have received with regard to the pet. If, for any reason, I am not able to care for my adopted pet, I will contact the Animal Care Society for acceptance Into the Center and re-adoption. The Society will determine whether or not the pet can be accepted for re-adoption. If the Animal Care Society demands the pet's return for any reason, I agree to promptly return the pet to the Center. I shall be personally responsible for the humane care and control of the pet, and l agree that your agent shall be allowed to see the pet at any reasonable time. I further understand that any donation I have given to the Animal Care Society is a donation towards its work in caring for pets. I give the Animal Care Society my permission to obtain information from veterinarians who have seen/treated my pets.

Adoption Application

Step 1 of 5

Please complete the following for all pets you currently have or have owned in the last ten years