Adoption Application
Thank you for considering a shelter pet! To better serve you, please answer the following questions:
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Email *
Adoption Application
Name of animal you are interested in: *
We cannot guarantee that the animal will be held for you.
I am interested in: *
(Select all that apply.)
Your Name: *
(First and last.)
Phone Number: *
A number where you are most easily reached.
Home Address: Street, City & State *
(If you have lived at your current address less than a year, please list the second most recent address as well.)
If you rent, please list your landlord's phone number:
Do you currently own any pets? *
If you own pets, are they spayed or neutered? *
If you own pets, do they have current rabies vaccinations? *
If you own pets, please tell us who your veterinarian is? *
If you own pets, please list their names, species and ages. *
Randolph County has a leash law in effect as do many other areas. How do you plan to contain your new pet? *
(Choose all that apply.)
Have you ever been issued a warning or citation for an animal control ordinance violation or had an animal legally removed from your care? *
Please list all members of your household, their ages and gender: *
I certify that the above information is correct to the best of my knowledge.  I understand that failure to answer honestly may result in denial of adoption. *
(Sign and date.)
A copy of your responses will be emailed to the address you provided.
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