Adoption Application

Thank you for filling out our online application, you must be 21 or older to adopt. Please answer all questions in order to submit.

What animal are you interested in?


Applicant/Co-applicant Profile

Your name

Co-applicant name

Your email

Your telephone number

Physical address

Mailing address (if different)type N/A if same

Drivers license number & state

Do you own of rent your home?

ownrent

If you rent, have you paid all pet deposits?

yesnonot applicable

How long have you lived at this address?

Any plans to move in the near future?

yesno



Family/Household Information


How many adults in the household?

Have all the adults in the household agreed to this adoption?

yesno

Ages of children in household (if none write none):

Have the children had pets before?

yesnoN/A

Any allergies to pets?

yesno

if yes, explain.

Why would you like to adopt an animal from us? Check all that apply.

Companion for selfCompanion for childCompanion for another petCompanion for another household memberGuard/ProtectionGift

Is this your first pet?

yesno

Do you currently have pets?

yesno

Please list current pets. Name, Breed, age, gender, Spay/Neutered?

Have you ever given away or relinquished and animal?

yesno

If yes please explain.

Veterinarian's Name & Phone



New Pet Information


It takes time for animals to adjust to a new environment. Are you prepared to allow the time needed for your new pet to adjust to your home?

yesno

Are you committed to providing a responsible home for your pet’s entire life (10+ years)?

yesno

If you have to move, what do you plan to do with your pet(s)?

Who in the household will be the pets’ primary care giver?

Where will the pet be kept during the day?

At night?

How do you plan to house train your pet?

Do you have a fenced yard?

yesno

If no, how do you plan on containing your pet outside of your house?

How many hours per day will your pet be left alone?

What training techniques would you use if your pet: (Please be specific):

Digging:
Barking:
Chewing:
Separation Anxiety:
Aggression:
Failure to house train:

Please Note

Please understand that Home At Last Humane Societyis not a veterinary clinic and that this animal may be harboring a medical condition which is not apparent during its stay at the shelter. Should such a condition become apparent after adoption, you assume full responsibility for any related veterinary care. We strongly recommend that you take advantage of the free office visit included in the adoption, within two (2) weeks of adoption.
By clicking the submit button below, you have stated that all information on this application is true to the best of your knowledge. Home At Last Humane Societyhas the right to refuse an adoption if it is found that information stated on the application has been falsified.

Dog Adoption Application

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About You

Your Name (required)

Your Email (required)

What dog you want to adopt (required)

Primary Phone (required)

Secondary Phone

Address 1 (required)

Address 2

City (required)

State (required)

Zip Code (required)

County

About your home

Type of home you live in (required)
ApartmentDuplexHouseMobile Home

Do you rent or own?
RentOwn

Landlord's Name

Landlord's phone number

How long have you lived at this address?

Do you anticipate moving?
YesNo

Your ability to care for a pet

Have you adopted from us in the past?
YesNo

If yes when?

Is the dog going to be living with you?
YesNo

If no where will the dog live?

Are you prepared to meet the financial responsibility of owning a pet? (A cost of $300 to $500 per pet, per year)
YesNo

Have you had other pets in the last 5 years?
YesNo

If yes, where are they now?

Do you have any pets at your residence? (If yes, please list their breed, sex, age, and if they have been spayed or neutered.)

How many people live in your household?

Do the adults in the household know you plan to adopt?
YesNo

Do you have children?
YesNo

If yes, what are their ages?

Who is your veterinarian?

Veterinarian's phone number:

Why do you want a dog?

Do any of your family members have allergies to any animal?
YesNo

What size dog do you prefer?
SmallMediumLargeExtra Large

Breed?

Hair / Coat?

Please tell us the characteristics you would like in a dog?

Of these characteristics which are critical to you

What type of lifestyle do you have?

How many hours a day will the dog be WITHOUT adult care?

Do you have a fenced yard?
YesNo

If yes, fence height?

If no please tell us how you intend to exercise and potty the dog?

Where will the pet sleep?

How much time will the dog spend:

Indoors?

Outdoors?

If the dog will be outdoors, is there shelter or a doghouse available?
YesNo

Thank you for taking the time to answer our questions. We hope that by going through this process, we will reduce the chance of an inappropriate match both for you and for our animals. If you have any comments regarding this adoption application or our adoption process, please feel free to let us know as we are always looking for ways to improve! Again, thank you for considering a rescue pet and saving a life.

How did you hear about us?

How did you hear about this animal?

By submitting this application I understand that I may not surgically alter any dog I adopt from Home at Last, at any time, unless medically necessary. Doing so will result in the breaking of the adoption contract, and Home at Last may take any appropriate action for the welfare of the animal as noted in the adoption contract. I understand that this potentially debilitating procedure may lead to behavior problems.

I am aware that Home at Last has examined this dog, provided preventive medical care, and disclosed in writing all known medical issues. I understand that all animals can carry and transmit disease, some of which may affect other animals and/or people and that these diseases may be undetectable in what appears to be a healthy cat at the time of adoption. I understand that my new dog may have been exposed to contagious diseases such as ringworm and bordetella, and upper respiratory infection, and that these conditions are usually highly treatable. I accept this dog as AS IS at the time of adoption, taking responsibility for the dog’s care and well-being, including all medical care which may be necessary after the time the dog is released into my care. I understand that Home at Last is not responsible for any medical conditions not detected prior to the time of this adoption. I understand that I should keep my new dog isolated from other pets for a minimum of seven (10) days

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The following information will help us more quickly answer your question (sometimes all it takes is a quick phone call so please include your phone number).
We keep your information strictly confidential.

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Cat Adoption Application

afdc
About You

Your Name (required)

Your Email (required)

What cat do you want to adopt (required)

Primary Phone (required)

Secondary Phone

Address 1 (required)

Address 2

City (required)

State (required)

Zip Code (required)

County

About your home

Type of home you live in (required)
ApartmentDuplexHouseMobile Home

Do you rent or own?
RentOwn

Landlord's Name

Landlord's phone number

How long have you lived at this address?

Do you anticipate moving?
YesNo

Your ability to care for a pet

Have you adopted from us in the past?
YesNo

If yes when?

Is the cat going to be living with you?
YesNo

If no where will the dog live?

Are you prepared to meet the financial responsibility of owning a pet? (A cost of $300 to $500 per pet, per year)
YesNo

Have you had other pets in the last 5 years?
YesNo

If yes, where are they now?

Do you have any pets at your residence? (If yes, please list their breed, sex, age, and if they have been spayed or neutered.)

How many people live in your household?

Do the adults in the household know you plan to adopt?
YesNo

Do you have children?
YesNo

If yes, what are their ages?

Who is your veterinarian?

Veterinarian's phone number:

Why do you want a cat?

Do any of your family members have allergies to any animal?
YesNo

Is this your first experience with a cat?
Yesno

You want to adopt this cat for?

Where will the adopted cat live?

Who will be responsible for the care of this cat?

By submitting this application I
understand that I may not declaw any cat I adopt from Home at Last, at any time. Doing so will result in the breaking of the adoption contract, and Home at Last may take any appropriate action for the welfare of the animal as noted in the adoption contract. I understand that this potentially debilitating procedure may lead to behavior problems. If I have any problems with my cat scratching, I will turn to Home at Last and my Veterinarian for assistance to resolve the problem effectively and humanely, without resorting to surgical declawing or a tendonectomy.

I am aware that Home at Last has examined this cat, provided preventive medical care, and disclosed in writing all known medical issues. I understand that all animals can carry and transmit disease, some of which may affect other animals and/or people and that these diseases may be undetectable in what appears to be a healthy cat at the time of adoption. I understand that my new cat may have been exposed to contagious diseases such as ringworm and feline upper respiratory infection, and that these conditions are usually highly treatable. I accept this cat as AS IS at the time of adoption, taking responsibility for the cat’s care and well-being, including all medical care which may be necessary after the time the cat is released into my care. I understand that Home at Last is not responsible for any medical conditions not detected prior to the time of this adoption. I understand that I should keep my new cat isolated from other pets for a minimum of seven (7) days.

Thank you for taking the time to answer our questions. We hope that by going through this process, we will reduce the chance of an inappropriate match both for you and for our animals. If you have any comments regarding this adoption application or our adoption process, please feel free to let us know as we are always looking for ways to improve! Again, thank you for considering a rescue pet and saving a life.

How did you hear about us?

How did you hear about this animal?

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