Adoption Application

First name **Must be a minimum of 18 years old to adopt**

*

Last name

*

Address

*

City

*

State

*

Zip

*

Email

*

Cell phone

*

Home phone

*

What type of pet are you interested in seeing today?

*

Name of pet you are interested in meeting

*

Name of pet you are interested in meeting

*

How experienced do you feel you are for caring for this type of pet?

*

How experienced do you feel you are with providing veterinary care for your pet?

*

How would you describe your household?

*

Do you rent or own your home?

*

If you rent, please supply your landlord's name

*

... and phone number

*

Dog Adopters: What energy level are you looking for in a new dog?

*

Cat Adopters: What activity level are you looking for in a new cat?

*

Please tell us about the other dogs and cats currently living in your home. Please include name, pet type, age, spayed/neutered and vet/clinic info. If you would like to be added to our wishlist, please discribe what you are looking for.

*

I understand that:

Adopting a pet is a long term commitment
The Community Humane Shelter of Steuben County reserves the right to refuse/reject any application at its discretion
My electronic signature allows release of any information necessary to process this application
The Community Humane Shelter of Steuben County may perform a criminal background check as part of the application process.

Signature of applicant

*