Adoption Application

What is the name of the ANIMAL or ANIMALS you are interested in adopting?

This animal is a:

Where did you see this animal posted for adoption?

Your Name

First NameLast Name

Email

example@example.com

Phone

Please enter a valid phone number.Format: (000) 000-0000.

May we text you at this number?

Secondary Phone

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How long have you lived in your current home?

What type of dwelling do you live in?

If you live in a trailer court, which one?

Do you currently rent or own your home?

Landlord's Name

Landlord's Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

How many people live in your home?

What are the ages of any children in your home?

Are you employed?

Does anyone smoke INSIDE the home?

Where are you employed?

Reason not employed

Other

Have you ever been convicted/charged with animal cruelty or neglect? If yes, when?

How many pets do you currently have?

List Names, Species, Breeds, and Ages of your CURRENT animals:(if you don't have animals, please enter NONE)

Rows	Name	Age	Breed
Dogs
Cats
Farm Animals
Exotics

Please list any animals you've had in the PAST 5 YEARS (include names, type of pet, breed, age, sex, spayed/neutered status, indoors or outdoors pets).

Will your new pet be kept inside, outside, or both?

Do you have a fenced in yard?

Who is your current veterinarian? (If you do not have a current vet, who do you intend to use as a vet for this pet?)

First NameLast Name

Phone number of vet:

Please enter a valid phone number.Format: (000) 000-0000.

Is the vet listed above, your current or future veterinarian?

Please call your veterinarian and allow the release of your pet's medical records to us.

What name is the vet account under?

First NameLast Name

Are your animals up to date on shots?

Are your animals spayed/neutered?

If your current animals are not up to date on their shots and/or are not spayed/neutered, please explain why.

What is it about this particular animal that draws your interest?

How did you hear about this animal/shelter?

If your selected dog or cat has already been adopted, would you be interested in another if we were to suggest a similar animal?

Would this be your first pet?

Where and with whom will your pet spend most of his/her time?

Are you aware that the dog you want to adopt may need to be re-house-trained due to them being in a kennel environment, which is different than a home.

If your adopted cat or dog has behavioral issues, how will you deal with those? (For example with a cat: What if he/she claws your furniture? Gets on surfaces you do not wish him/her to jump on? For a dog: What if he/she jumps too much? Nips at your hands too hard? Chews on shoes, etc.?)

Additional Comments:

Reference #1 – Please provide the name and phone number of a NON FAMILY reference.

Reference #2 – Please provide the name and phone number of another NON FAMILY reference.

Hometown Heroes Discount (25%): Are you military, police, fire, or EMS? (an ID will need to be presented at the time of adoption to receive the discount)

Adoption Application

Fulton County Humane Society