Cat Adoption Application

Congratulations on your decision to adopt an animal companion for your family.
Our goal at Adams County Humane Society is to find permanent, safe, loving, and
responsible homes for the animals in our facility. We will work with you to help
you find the best animal for your lifestyle and family.

Adams County Humane Society Cat Adoption Application

Requirements to Adopt From ACHS

Fill out this adoption application completely
Must be 18 years of age or older
Provide valid photo identification that includes your date of birth
Ensure that any current pets are up to date on rabies and distemper vaccinations
If you rent, speak with your landlord in advance about their pet policies
- Note: We will contact your landlord to verify pet approval before finalizing your application

EVERY ENTRY MUST BE COMPLETED OR THIS APPLICATION WILL NOT SUBMIT CORRECTLY!

Enter "N/A" if a question does not apply to you.

* Indicates required field

Date of application *

Name of the Cat You Want to Adopt *

Phone Number *

Your First Name - Middle Initial - Last Name *

Your Date of Birth *

Partner's First Name - Middle Initial - Last Name -- Enter N if this does not apply. *

Partner Date of Birth - Enter N if this does not apply. *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Your Email *

Microchip Emergency Contact - All cats adopted from ACHS will be microchipped. Please list the name and phone number of someone you trust if your cat ever gets lost. *

First

Last

Contact Phone # *

Financial/Employment

List all sources of income for each adult member of your your household. Include the name of each employer and the length of time employed. *

Household

Do you own or rent? *

Name of landlord or parent. Enter N in each space if this does not apply. *

First

Last

Phone Number - Enter N if this does not apply. *

Please list the full name and age of all people living in the home where this animal will reside. Include the date of birth for everyone 18 and older. *

Comment *

Have you ever adopted from ACHS before? *

Have you ever surrendered a pet to a humane society, rescue, or shelter? *

Does anyone in the home have allergies? *

If yes, please explain why. Enter N if this does not apply to you. *

I have owned a dog or cat before. *

My new cat needs to be good with kids: *

My cat needs to get along with cats. *

My new cat needs to get along with dogs. *

I want a pet who is by my side *

My home is best described as: *

How many hours a day will this cat be alone? *

When I am gone my cat will be: *

The most important trait in my new cat is *

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 do not currently have other pets.

List the following for each dog: name, male/female, age, breed, and if they are spayed/neutered. Write NONE if you don't have a dog living with you. *

List all your cats, ages, and if they are spayed/neutered. Write NONE if you don't have a cat living with you. *

If any of your pets are not spayed/neutered explain why. Enter N if this does not apply to you. *

Veterinarian Clinic's Name *

Veterinarian Clinic's Phone # *

ACHS offers free pet insurance for one month with adoptions. This only covers illness or injury and does not cover routine visits. Would you like this insurance? *

Yes No

Please read then check each box that you understand the following conditions of adopting from our shelter: *

ACHS has the right to accept or deny this application for any reason. No explanation will be given for a denied application. We choose the home we feel is the best home for the animal based on the application and the interaction with the family. A filled out application does not guarantee your application is approved. Information provided is true to the best of my knowledge. Falsifying information will result in a denial of my application. The adoption process and the adoption fee involved with adoption. ACHS does not guarantee the temperament, age, breed or health of any animal and I agree to hold ACHS harmless for any damages the animal may do to any person or property. All cats adopted from ACHS must be kept indoors at all times. ACHS has the right to come to your home and complete an animal welfare check for all animals adopted from our facility.

I hereby state I have read the above statements and agree to abide by these conditions.

Type your name below as an electronic signature. *

Today's Date *

EVERY ENTRY MUST BE COMPLETED OR THIS APPLICATION WILL NOT SUBMIT CORRECTLY!

Enter "N/A" if a question does not apply to you.

We have had problems with receiving submitted applications. Until the problem is resolved, after clicking the submit button below, please email [email protected] to let us know you have submitted an application. Thank you for your patience!

**ACHS reserves the right to deny any adoption application received.

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