Cat Adoption Application

ADAMS COUNTY HUMANE SOCIETY

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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 a Wisconsin resident.
* Must be 21 years of age or older.
* Have proper identification (driver's license, etc.)
* Current pets must be up to date on rabies and distemper vaccinations.
* ACHS will check with landlords or parents for approval if either of these applies to you.

EVERY ENTRY MUST BE COMPLETED OR THIS APPLICATION WILL NOT SUBMIT CORRECTLY! Enter the word NONE 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 *

Partner Date of Birth *

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

Where do you live? *

House Apartment Mobile Home Condo Live With Parents or Relative

Do you own or rent? *

Name of Landlord or Parent *

First

Last

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Phone Number *

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. *

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.

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.

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. *

Veterinarian Clinic's Name *

Veterinarian Clinic's Phone # *

Personal Reference * * Your personal reference cannot be related to you by birth or marriage. *

First

Last

Personal Reference Phone # *

* Your personal reference cannot be related to you by birth or marriage.

By typing in your name below you give ACHS permission to check your reference. *

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 Litter training Grooming/nail trimming Exercise, toys and fun activities Kitten-proofing your home Finding a veterinarian Moving with pets Flea/tick prevention Heartworm prevention Declawing Microchipping your other pets Low cost vaccinations Introducing a new pet to your pets None of the above

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 a temporary signature. *

All Adoptions Are by Appointment Only for Approved Applicants
+ You will receive a call from ACHS to schedule an appointment ONLY IF YOUR APPLICATION IS APPROVED.
+ We have a right to deny any adoption application received.
You will not be given an explanation of why you were denied.
+ This is the policy of ACHS and is enforced with every application.

Please make sure you have completed each question or your application will not submit. Contact ACHS to make sure we received your application.

You will sign here when you come to ACHS to your scheduled adoption appointment. *

Submit

Thank You!

1982 11th Ave, Friendship, WI 53934
Phone: 608-339-6700
[email protected]

License #266944-DS

Click Here to Contact Us

Home
Adopt
- Adoptable Animals
- Adopted Animal Adjustment to New Home
Volunteer/Foster
- Volunteer
- Foster
Events
Easy Ways to Help
About ACHS
Animal Wellness & Safety
More Services