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Adoption Application
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* Indicates required question
Adopter Information
Please check the boxes that apply:
*
I am at least 18 years old
I have consent of all adults within the household to adopt this animal(s)
I have a valid picture I.D.
I understand I may be refused the adoption of the animal(s)
Required
Date:
MM
/
DD
/
YYYY
Name:
*
Your answer
Full Address
*
Your answer
Email
Your answer
Phone Number
*
Your answer
Please list 2 references (non-family) name, phone number, and relationship to you.
*
Your answer
Vet Information
Please list the name the account is under if different from yours:
Your answer
Do you currently have an established veterinarian?
*
Yes
No
I currently do not have animals
I am looking
Who is your current veterinarian?
Your answer
Please list their address and phone number below:
Your answer
I want to adopt a:
*
Adult dog
Puppy
Adult cat
Kitten
Required
Animal(s) name you're interested in adopting
*
Your answer
If you currently have pets, please list them below:
*
Your answer
Are your current pets spayed/neutered?
*
Yes
No
Some
I currently don't have pets
Have you had pets in the past you no longer own?
*
Yes
No
If yes to the above question, why do you no longer have them?
Your answer
Do you:
*
Own your home
Rent
If you rent, please provide your landlord's name and phone number below:
Your answer
Can you financially provide all necessary medical treatment/wellness visits for the duration of the animal(s) life?
*
Yes
No
Do you have children that live with you?
*
Yes
No
If yes to the above question, please state their ages below:
Your answer
CAT/KITTEN ADOPTIONS ONLY
(Dog adoptions, please scroll down)
Why do you want this animal(s)
Your answer
Have you euthanized an animal?
Yes
No
Clear selection
If yes to the above question, please explain below:
Your answer
Will this animal(s) be indoor or outdoor?
Indoor
Outdoor
Both
Clear selection
Is anyone in the household allergic to animal dander?
Yes
No
Unknown
Clear selection
Do you plan on declawing the pet?
Yes
No
Unsure
Clear selection
Have you ever turned an animal over to a shelter?
Yes
No
Clear selection
If yes to the above question, please explain below:
Your answer
If you leave home for an extended period of time (like a vacation), what are your plans for the animal(s)?
Your answer
DOG/PUPPY ADOPTIONS ONLY
Why do you want this animal(s)
Your answer
Have you euthanized an animal?
Yes
No
Clear selection
If yes to the above question, please explain below:
Your answer
Is anyone in your household allergic to pet dander?
Yes
No
Unsure
Clear selection
Where will this animal be primarily located?
Indoors mostly
Outdoors mostly
Outdoor only
Clear selection
Are you familiar with the animal laws in your town?
Yes
No
I live outside the city limits
Clear selection
If yes to the above question, please list the laws below:
Your answer
What is the atmosphere in your home like?
Quiet
Some activity
Very active
Clear selection
Do you currently have a fenced in backyard?
Yes
No
Clear selection
Will this animal(s) be crated anytime?
EX: In a black wire crate while at work
No
Yes, more than 8 hours/day
Yes, less than 8 hours/day
Clear selection
If you leave home for an extended period of time (like a vacation), what are your plans for the animal(s)?
Your answer
I understand if I adopt an animal from the Carthage Humane Society, I plan on keeping this animal for the duration of its life. If for any reason, I can no longer keep this animal, I will contact the Carthage Humane Society to return the animal if space allows.
*
I agree
I do not agree
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