Adoption Application

* Indicates required field

Which pet would you like to adopt? *

Where will this pet live? *

Inside only Mostly inside Mostly outside Outside only

Description of Animal *

Your Name *

First

Last

How will this pet be contained while outdoors? (if applicable) ie. chain, kennel, leash, fence, run loose, etc. *

Secondary Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

What are some of the most important things you are looking for in a new pet? *

Are there children who visit your home? If so, please list ages. *

Current Pets *

Date of Birth *

Phone number *

Do you own your residence? *

If no, please list your landlord's name and phone number. *

If the pet you have applied for is unavailable or we feel that it is not the best match for you, would you like for us to process your application and help you find different pet? *

Yes No

Previous Pets *

Are your pets spayed or neutered? *

Yes No Some, not all

Are they current on their yearly vaccinations? *

Yes No Some, not all

Veterinarian's name and phone number *

References may be checked, so please contact your Veterinarian prior to submitting this application and give them permission to release a copy of your records to us. Please verify that this has been done. *

Yes No Not applicable

Do you understand that if you adopt a pet and cannot keep it, it MUST be returned to the Logan County Humane Society and not given away or sold? *

Yes No

Do you understand that the Logan County Humane Society has the right to reclaim any adopted animal who we feel is being misstreated or who is being treated in a manner that is inconsistant with the information on this application? *

Yes No