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Effingham County Animal Control-Shelter            License #171 
Please answer all questions fully. The more details you provide, the better chance you have at being matched with your perfect pet. Thank you.
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Adoption Application for: *
Adopter's Name: *
Date of Birth: *
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Co-Adopter's Name:
Date of Birth:
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Full Address (where pet would be living): *
Phone Number(s): *
Email Address:
Do you Own or Rent your home? *
If Renting: Pets Allowed? Yes/No. Name and phone number of landlord:
How long at current address? *
Names, types, and ages of current pets: *
Do you have children or children that visit your home often? If so, how old? *
What is your occupation?
Veterinarian Reference: *
Vet Clinic Phone Number: *
Vet Clinic Address:
Are you a first time pet owner? *
Who will be mainly responsible for this pet? *
What do you think is a reasonable amount of time for this pet to adjust to your home and what behavior expectations do you have? *
What issues would compel you to give up this pet? *
Required
Do you or anyone in your home have allergies? Yes/No Describe: *
How do you plan to transition your new pet in with your current pets? *
Do you have a fenced in backyard?
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Would your pet be indoor, outdoor, indoor/outdoor? *
Do you have a Facebook page? If so, what is your name on your Facebook?
Comments or other things we should consider in regards to your application (ie: tell us why you feel this pet is a good fit for your home. What concerns do you have?):
Thank you for taking the time to fill out this application, which will help us to match you with the right pet. There may be up to a week waiting period to process paperwork. Completion of this form does not guarantee that ECACS will place a pet in your care. I understand that if a pet is placed with me, I will pay a NON-REFUNDABLE adoption fee. I certify that the information I have provided is accurate, and that any misrepresentation of facts may result in my losing the privilege of adopting a pet through ECACS.
*If your application is approved ECACS will contact you for a meet and greet time*
I Agree: *
**If your application is approved we will call you to set up a meet and greet appointment time**
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