Adoption Application

Please fill the form out completely, including any past pets and vet information. Please allow up to 10 business days to process application before you contact us. Please do not call. If you haven’t been contacted in 10 business days, please email us at general@humanesocietyhoco.org

Personal Information
Date
Which pet(s) are you interested in adopting?*
Which pet(s) are you interested in adopting?
Name*
First Last
Occupation*
Occupation
Home Address*
Home Address

Street Address Address Line 2 City State ZIP Code
Home Phone*
Home Phone
Work Phone*
Work Phone
Cell Phone*
Cell Phone
Email
Email
Facebook URL*
Facebook URL
Adopter Age
Adopter Age
Household Information
Years at your present address*
How long have you lived at your present address?
How did you hear about us?*
How did you hear about us?
Rent or Own?*
Rent or Own?
Adults living in the home and ages (including yourself):*
Please list all adults living in the home and their ages (including yourself):
Children living in the home and their ages:*
Please list all children living in the home and their ages:
Young children (under 15) that visit the home
Are there any grandchildren or young children that visit the home?
Fence - height, material, etc:*
Fence - How high and what is it made of (chain link, stockade, invisible, etc):
Do you already or have you ever had dogs?*
Do you already or have you ever had dogs?
Dogs info
Do you already or have you ever had cats?*
Do you already or have you ever had cats?
Cats info
Do you have or have you ever had any other animals?:*
Do you have or have you ever had any other animals?
Other animals info
Have you owned a dog or cat before?*
Have you owned a dog or cat as an adult before?
When did you own the previous pet?
When did you own the previous pet?
What breed was the previous pet?
What breed was the previous pet?
What happened to the previous pet?
What happened to the previous pet?
What is your work schedule?*
What is your work schedule?
How long will the pet be alone?*
How long will the pet be alone?
Where will the pet be when alone?*
Where will the pet be when alone?
Where will the pet be during the day?*
Where will the pet be during the day?
Where will the pet be at night?*
Where will the pet be at night?
Exercise Plan, please explain:*
Exercise Plan, please explain:
How will the pet be cared for when you are gone?*
How will the pet be cared for when you are out of town?
Life Plan*
Life Plan: Do you have someone in place who would be willing to take your pet(s) in if something were to happen to you?
Life Plan info
Do you have experience with crate training?*
Do you have experience with crate training?
Are you willing have a Humane Society of Houston County volunteer visit your home by appointment?*
Are you willing have a Humane Society of Houston County volunteer visit your home by appointment?
Ideal pet (Color/Gender/Age/Activity/Mix?):*
Ideal pet (Color/Gender/Age/Activity/Mix?):
Notes (please use this space to tell us any additional information and/or which dog/cat you might be specifically interested in):
Most Recent Veterinary Information for Your Pets
Note: If you have never had a vet, please list an additional reference here.
Veterinarian's Name:*
Veterinarian's Name:
Vet's Business Name:*
Vet's Business Name:
Vet's Address:*
Vet's Address:
Vet's Phone:*
Vet's Phone:
Acknowledgement
I agree to allow the Humane Society of Houston County, Inc. to contact my vet or any of the people listed as references on this application to discuss the information listed herein. I have answered the above questions truthfully and to the best of my ability. I also understand that the Humane Society of Houston County, Inc. may refuse or deny my application for adoption on any grounds. I understand that if I am e-mailing this application, my e-mail is my signature. Further, my signature below indicates that I am at least 21 years of age and intend to be the legal owner and the person responsible for the care and well being of any animal I adopt from the Humane Society of Houston County, Inc.
Acknowledgement*
- I agree
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Personal Information

Household Information

Most Recent Veterinary Information for Your Pets

Acknowledgement