Adoption Application

Animal Name*

Type of Animal*

How did you hear of us*

The information given here is confidential and will only be used for adoption purposes. For more information, please contact us at jaspercountyhumanesociety@gmail.com

Before you start, please make sure you are eligible to adopt.

Adoption Process Requirements:

1. The adopter must be at least 18 years old.

2. The adopter must have identification showing present address.

3. Consent of all adults living in your household.

4. Owner/landlord consent if renting. We will be reaching out to them, so please arrange this in advance. (Many apartments or landlords have breed or size restrictions even if they do allow dogs.)

5. A veterinarian reference check for any current pets. All pets must be up to date on vaccinations and preventatives. We cannot, and will not, process any applications if your pets are not up to date. If you fill out the application and your animals are not current we cannot process your application UNTIL all pets are brought up to date, which will likely delay the process.

6. If the match is agreeable by both the applicant and JCHS, a home visit will be conducted.

7. Once the home visit is conducted, a meet and greet will be scheduled with ALL 2 and 4 legged occupants of the home.

8. If meet and greet goes well, the animal will be left under the adopter's supervision for a "trial period". Trial period will be 2-3 days of undivided attention given to all furbabies inside the home. If this will be your first pet, it is mandatory that a relationship be established with a vet with our animal.

9. Trial period is up to adopter. The goal is to make sure every living occupant is happy with the arrangement before a final adoption occurs. Once final adoption occurs, we need to know that this animal will be given a lifetime of loyalty and love.

10. After trial period, contract is signed, and adoption fee is paid.

Name*

First NameLast Name

DOB*

Date

Phone Number*

Please enter a valid phone number.

Spouse/Partner/Roommate Name(s)*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Do you:

Own HomeRent Home (landlord approval will be needed)Live with family/friends

If you rent your home, name and phone number of landlord:

Number of people living in household? *

If any minors live in household, what are the ages?

Is everyone in the household in agreement with adopting a pet?

YESNO

Email*

example@example.com

References (include a minimum of two, name and phone #)*

Please add phone numbers

Current Employer and phone number*

Current Veterinarian (please include phone #)*

What animals now live on your property? Please list type, breed, age, sex and if animal is spayed/neutered. If not, please list why.

If you have animals, what type of heartworm/flea/tick prevention do you currently use?

Are your current pets up to date on ALL vaccines?

YESNO

If not, please list why

Have you had other pets as an adult? If so, list why you no longer have them

How many hours a day will your pet be left alone without a human companion?

Where will this dog stay while left alone?

Where will the dog sleep?

If this dog is not housebroken, are you willing to take time to help it learn how to live life on the inside of a home?

YesNo

What sort of training do you plan/are you willing to provide for this dog (i.e. crate training, house training, obedience class, etc.)?

How do you plan to exercise this dog?

Where will your new dog go when you travel?

How do you feel about crate training? *

If you could no longer care for your animal(s), do you have a plan to provide for their continuing care? If so, what is it?

Living arrangements for animal being adopted:*

IndoorFenced YardOutside PenOther

If your yard is fenced, what type of fence do you have?

Do you have any training or behavior questions you'd like to address in the adoption process? *

Is there anything else you would like for us to know?

I understand the Jasper County Humane Society has the right to disallow any adoption for any reason.

I understand the Jasper County Humane Society has the right to visit my new dog or cat and verify their living conditions and health.

I understand, agree, and accept that if the Jasper County Humane Society for any reason finds the placement of this animal not acceptable, they will reclaim the animal.

I release the Jasper County Humane Society and their agents of any liability relative to this adoption.

Important‼️‼️

This animal may not be transferred to a new owner for any reason without prior approval from the Jasper County Humane Society.

I understand and agree that the adoption fee for this animal will be at the current advertised fee(includes spay/neuter certificate, rabies, and microchip). *

Adoption Application

ADOPTER INFORMATION