Adoptions Adoption Application Printable Adoption Application To ensure your application is properly submitted, please read the following:*Make sure to answer ALL questions on the application. If a question does not apply to you, please enter "0" or "NA"! You will be taken to a confirmation page after your application has been successfully submitted!Adoption FeesDog: $155; Cat: $100Identify what animal you are looking to adopt.* If not animal specific, please type 'none"Is the animal a cat or dog?* Cat Dog Part 1- Personal InformationName* First Last Spouse's Name First Last Date MM slash DD slash YYYY Time* : Hours Minutes AM PM AM/PM Phone*Physical Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Are you a veteran? Yes No Are you over 68? Yes No Employeer* Occupation* Spouse's Employeer Spouse's Occupation Do you own your own home?*YesNoDo you own the land your home is on?*YesNoIf no to either, Landlord's Name First Last Landlord's NumberAre you over the age of 18?*YesNoDo you plan to move in the next 6 months?*NoYesPart 2- Prior/Current Pet InformationList all pets that are currently in your home or visit frequently.*Include: name, species, breed, age and sex. Are they currently all spayed/neutered* Yes No Are they currently up to date on their vaccination* Yes No Have you ever surrendered an animal to the shelter?* Yes No List of the pets you have previously owned, in the last 10 years.*Include: reason why you no longer have the animal. Veterinarian* Phone Number of Veterinarian's Office*Part 3-General InquiresDo you have any children in your home?* Yes No If yes, what are their ages?* Please list any additional people that reside with you for an extended period of time.On average, how long will the pet be alone during the day?* How do you plan to deal with behavioral issues if they arise?Part 4-Dog Specific QuestionsComplete these questions only if interested in a dog. How is the dog going to be contained to your property?Have you owned a dog in the past? Yes No Have you adopted a dog from a shelter in the past? Yes No Are you familiar with crate training? Yes No Are you familiar with house breaking? Yes No Is this going to be an indoor or outdoor dog? Indoor Outdoor Both Are you familiar with grooming needs? Yes No Part 5-Cat Specific QuestionsFill out if interested in adopting a cat. Is this going to be an indoor or outdoor cat? Indoor Outdoor Both Do you plan on declawing? Yes No Have you adopted a cat from a shelter in the past? Yes No Are you familiar with grooming needs? Yes No Part 6-Personal References ( NON FAMILY)List 2 non-family personal references.Name* First Last First ReferencePhone*First referenceRelationship* First referenceName* First Last Second ReferencePhone*Second ReferenceRelationship* Second ReferenceHiddenMUST READI certify that the above information is accurate and complete to the best of my knowledge. I understand that the CSPCA has the right to reclaim the animal if any given information is found to be false. I authorize the release of veterinarian information related to my current and past pets. I understand that there are costs associated with owning a pet, that the costs can range from $400-$800 annually and that there may also be additional cost due to injury or illness.MUST READ* I agree to these terms.I certify that the above information is accurate and complete to the best of my knowledge. I understand that the CSPCA has the right to reclaim the animal if any given information is found to be false. I authorize the release of veterinarian information related to my current and past pets. I understand that there are costs associated with owning a pet, that the costs can range from $400-$800 annually and that there may also be additional cost due to injury or illness.HiddenSign Here:Online Signature* Please type your full name confirming that you have read and understand the above statement. Look for our Confirmation Page to ensure your application was submitted to us!You will be redirected to a confirmation page!CommentsThis field is for validation purposes and should be left unchanged. Δ Our Proud Sponsors and Partners
