Adoption Application

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. Please complete the adoption application completely, as incomplete applications will drastically slow down the process and the animal you are looking at may be adopted before we can complete processing your application.

In order to be considered for adoption, you must:
* Be 18 years of age. If under 21 you must be a home owner or the person on the renters agreement in an apartment, house or trailer . Proof of ownership or renter agreement may be required.
* Current pets must be up to date on rabies and distemper vaccinations.
* ACHS will check with landlords for approval of pets in rental homes/apartments/condos. If you live at home with your parents we will have to call them as well, as they are the home owners. It is always a good idea to touch base with your landlord letting them know you are looking for an animal before we call them.

* 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

How did you hear about ACHS? *

Cell Phone Number *

Home or other cell Phone Number *

Email *

Do You: *

Own your own home Rent your home

Landlordor name and phone number (or parents if you live with them) *

Number of people and ages in the household (including those who visit on a regular basis, i.e. children who you share custody of, etc.) *

Will everyone in the household be present for the adoption? (we do not require everyone to be here) *

Yes No Unsure

Have you ever owned a dog before? *

Have you ever adopted from ACHS before? *

I want my dog/cat to be an: *

Inside only animal (dogs out for potty & play) Inside/ outside animal Outside only

My new dog/cat needs to be good with: *

All age kids Kids under 5 Kids 5-10 No, We have no kids that come around

Have you ever owned a cat before? *

If you picked inside/ outside or outside only please explain: *

When I am not home my new dog/cat will be: in a crate, loose in the home, confined to a room, outside or something else? Please explain. *

I want my dog/cat to be playful *

Very Somewhat Not at all

My home is best descrined as: *

Quiet Moderatley Active Chaotic

My new dog/cat needs to get along with dogs: *

Yes No, not important

Do you have livestock or poultry at home? *

My new dog/cat needs to get along with cats: *

Yes No, not important

When I am home, I want my dog/ cat by my side: *

All the time Some of the time Little of the time

I am comfortable doing training with my dog to improve manners: *

No Training Some Training A Lot of Training

How long would your new dog be alone during the day? *

What is your definition of disciplining your dog? *

The most important trait in my new dog or cat would be? *

Please provide the information of your current pets and in the past 5 years: Name, Breed, Age (or age of passing), male/ female, spayed/ neutered, do you still own. *

If your current dogs/ cats are not spayed or neutered, please list the reasons why: *

Name of Veterinary Clinic you use *

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. Animals will be held no more than 1 day after an application is approved. I understand that ACHS does not guarantee the temperament or health of any animals and agree to hold ACHS harmless. By typing in your name below means you have read and agree with the above. *

Veterinary Clinic phone number *

Do you give ACHS permission to do background check on the information you have provided? *

Yes No

Comments *

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