Adoption Application

Home / Adoption Application

Adoption Application

This is the form used for Adoption Applicants.

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
DOB*
Drivers License #*
Employer*
Income Estimate
Are you financially able to care for a pet? (This includes, vet visits, grooming, feeding, etc.)*
What pet are you applying to adopt?*
Name and breed of pet interested in {First and second choice}*
Are you renting your residents*
Housing Type*
If other, please specify
Landlord's Name
First Last
Landlord Phone Number
Number of people living in home*
Number of Children in Home.*
How many hours will the pet be left alone?*
Is everyone in the home in agreement on adopting a pet?*
Have you ever adopted a pet before?*
From where?
Have your animals been spayed/neutered?*
Are you a Belmont County resident and own a dog?*
Do you currently own or reside with any pets? Please list breeds, ages, sex, and how long you have owned each.
Please list dog license numbers (seperate # by commas)
Have you ever surrendered a pet to a shelter or humane organization?*
If Yes, Please explain
How will the pet be exercised?*
Will the pet live indoors, outdoors or a combination of both?
How will the pet be kept safe and secure in your yard?*
What type of fence and how high?
Who is your Veterinarian?*
Vets Phone*
Under what name are records listed?*
First Last
At minimum it can take 2 weeks for the pet to adjust to its new environment. Do you have the time to spend?*
Our animals are alone for about 15 hours a day which means many are not crate or house trained. Do you have the time to put the dog on a schedule? This could take at least 2 weeks.*
Many times our animals come to us with unknown backgrounds. Do you understand that the pet may act differently when home than it would at the shelter? Do you understand that dogs need leadership and mental stimulation to be happy?*
Anything you would like us to know
Please list 2 references that we can contact.
Name*
First Last
Phone*
Name*
First Last
Phone*
Consent*
I agree
I certify that the above facts are true to the best of my knowledge and belief and I understand that I subject myself to disciplinary action in the event that the above facts are found to be falsified.

Check this box and sign below if this is true.
Signature*
CAPTCHA

Adoption Application

Adoption Application

Please list 2 references that we can contact.