Pendleton County DOG ADOPTION APPLICATION
Thank you for your interest in adopting a dog from the Pendleton County Animal Shelter.  In an effort to ensure the best possible placement for the dogs in our care, and to help improve our services, we ask that you fill out the following application completely.  All information will be kept confidential.  If you currently own a dog(s), we recommend that you bring them in to meet the dog you are interested in adopting.
Sign in to Google to save your progress. Learn more
Dog you are interested in
Your Name
Last Name, First Name
Address
Street, City, Zip
County
Clear selection
Phone
Alternate Phone
Email
How old are you?
Type of home you live in
Clear selection
How long have you lived at this residence?
Do you own or rent your home?
Clear selection
If you rent, does your landlord allow dogs?
Clear selection
If your name is not listed as owner of property, provide name and phone number for property owner:
How many adults live in your house?
Ages of children in house
Are all members of your household in agreement about adopting a dog?
Clear selection
Do any members of your household have asthma or allergies to dogs?
Clear selection
If yes, please describe:
Describe your household activity level (calm, highly active, etc):
In the event of a personal or family emergency, who would care for your dog, or what arrangement would you make for your pet’s care?  Please describe.
Do you currently own any other pets/animals:
Clear selection
If yes, list species (for dogs also list breeds and ages):
If you currently have a dog(s)…
Does he/she have a current county license tag?
Clear selection
If yes, in what county?
Clear selection
Is your dog spayed/neutered?
Clear selection
If not spayed / neutered, why?
Is your dog up to date on vaccinations?
Clear selection
If not up to date on vaccinations, why?
Please provide the name, address, and phone number of your veterinarian (if you do not currently have one, what veterinary practice do you plan to use?)
Have you ever given a pet away?
Clear selection
If yes, who was your pet given to:
Clear selection
Have you ever had an animal lost or stolen?
Clear selection
Have you ever had to retrieve your animal from a shelter or animal control?
Clear selection
Where will your dog be when you are home?
Clear selection
How many hours will your dog be alone during the day?
Do you have a fenced yard?
Clear selection
If yes, what type and height of fence?
If not, how will you keep dog on property when outside?  
If you have to move, what would you do with your adopted pet?
Are you willing and able to accept the long-term commitment and financial expenses that come with owning and properly caring for a dog?
Clear selection
For what reasons would you consider returning or giving up your adopted dog
Please read
In the event you are unable to keep the dog for any reason, you must contact the Pendleton County Animal Shelter.  If you have a friend or family member who is interested in the dog, we require that they sign all paperwork and we will transfer the dog to them.  

By submitting this application and signing a paper copy upon receipt of the dog, I am stating that I have answered all questions completely and truthfully.  In the event the Pendleton County Animal Shelter (at any later time) discovers a falsehood, the adoption shall be annulled and the dog seized.  I acknowledge that I have been informed the Pendleton County Animal Shelter reserves the right to deny any application.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report