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Adoption Application
Congratulations on your decision to adopt an animal companion for your family. The Adams County Humane Society is happy you are considering adoption from our shelter. The goal of the ACHS is to find permanent, loving, forever homes for the animals in our facility. Our goal is to match the best animal for your lifestyle and family.
In order to be considered for adoption, you must:
* Be 18 years of age.
* Current pets must be up to date on rabies and distemper vaccinations.
* ACHS welcomes adopters who rent or live in an apartment or condo! We want to alert you that some landlords and management companies have size and breed restrictions, limits on the number of pets, and/or require pet deposits or additional fees.
*
Indicates required field
Date of application
*
Please write name of animal you are interested in.
*
Your Name
*
First
Last
Your Date of Birth
*
Significant Other
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Best way to be reached by phone?
*
Cell
Home
Work
Cell Phone Number
*
Home Number
*
Email
*
Work Number
*
Best time of day to be reached?
*
Morning
Afternoon
Evening
Emergency Contact (Cannot be yourself):
*
First
Last
The emergency contact is used for registration of your new pet's microchip. This number will only be used in the event that your new pet goes missing, so that we are able to get your pet home quicker!
Emergency Contact Phone Number
*
Please tell us about the members of the new pet's household (e.g # of adults/seniors/children):
*
Tell us about your pets at home (check all that apply):
*
I have one or more dog(s)
I have one or more cat(s)
I have one or more small animal(s)
I'd like help with introducing a new pet to pet(s) at home
I do not currently have other pets.
If you currently have dogs, ACHS requires that they come to ACHS to meet the dog you are interested in adopting. This is not required for cats.
We will explain this new pet's medical and behavioral history during adoption counseling. Please check additional topics you would like us to discuss with you:
*
Feeding this pet
House training/litter training
Grooming/nail trimming
Exercise, toys and fun activities
Puppy/kitten-proofing your home
Finding a trainer
Crate training
Finding a veterinarian
Moving with pets
Pulling on the leash
Flea/tick prevention
Heartworm prevention
Declawing
Microchipping your other pets
Low cost vaccinations
Please read and check that you understand the following:
*
ACHS has the right to accept or deny this application for any reason.
We choose the home we feel is the best home for the animal based on the application and the interaction with the family.
If there is another dog in the household and you are wanting to adopt a dog we will have to test the ACHS dog and your dog to make sure they get along.
A filled out application does not guarantee your application is approved.
I hereby state that information provided is true to the best of my knowledge.
Falsifying information will result in a denial of my application.
I also sign that I understand how the adoption process works and the fees involved with adoption.
I understand that ACHS does not guarantee the temperament, age, breed or health of any animal and agree to hold ACHS harmless for any damages the animal may do to any person or property.
By typing in your name below means you have read and agree with the above.
*
Submit
Home
About
Contact Us
Employment Opportunities
>
ANIMAL CARETAKER
Adoptables & Information
Adoptable Animals
Adoption Application
Lost & Found
>
Lost Report
Spaying and Neutering
HOW TO HELP
Support Us
Faith's Fund
Wishlist
Volunteer
Volunteer Application
Events