CCAC Adoption Application
Welcome to our facility! We are glad you are looking for your new best friend here. In order to adopt from us, you must be at least 18 years of age, have identification showing your current address, the consent of your landlord if applicable, & be ABLE and WILLING to spend the TIME & MONEY necessary to provide training, medical treatment, & proper care for your new family member. Thank you for taking the time to answer each question in this application honestly & completely.

*We reserve the right to refuse any applicant. This application is the property of Calhoun County Animal Center, Inc.*

Date: *
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Animal Name:
Your answer
Your Name: *
Your answer
Date of Birth: *
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Address: *
Your answer
City, State, Zipcode: *
Your answer
Main Contact Number: *
Your answer
Secondary Contact Number (If applicable):
Your answer
Email Address:
Your answer
Place of Employment: *
Your answer
Who will be responsible for care of pet? *
Your answer
I am here to look for a: *
Required
Is this your first experience with a pet? *
Why do you want to adopt a pet? (Please choose all that apply) *
Required
Please list all pets (past and present) that you have owned in the last five years. Please list name, breed/species, age, if spayed/neutered, if you still have them, and if not, what happened to them: *
Your answer
Who is your veterinarian? *
Your answer
Under whose name and what address are records kept? *
Your answer
What type of heartworm preventative do you use? *
Your answer
Which of the following situations would lead you to surrender your pet? Please choose all that apply: *
Required
Have you ever surrendered a dog/cat to a shelter or a rescue? If yes, please explain. *
Your answer
Where do you plan to house this animal? (i.e. Inside, Outside, or Both) If both, please explain: *
Your answer
How many hours a day will you spend with this pet? *
Your answer
Should something happen and you had to relocate or could no longer care for your pet, what would you do? *
Your answer
If your pet becomes ill, what will you do? *
Your answer
How do you plan to exercise your pet? *
Your answer
Would you allow a shelter representative to do a home check? *
Where do you currently live? *
Do you own or rent? *
If you rent, does your landlord allow pets?
Name and phone number for landlord (if applicable):
Your answer
How long have you been at this address? *
Your answer
Do the all other adults you live with know you plan to adopt a pet (if applicable):
Household Information: Please list the number of adults (18 years and old) and number of children, plus ages of the children: *
Your answer
Is anyone in the home allergic to pets? *
If yes, how will you cope with this issue?
Your answer
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