Canine Adoption Form

For feline adoption, please submit a feline adoption form.

Name:Date:
Street Address:
Mailing Address (If different):
City: State: Zip:
Home Phone: Mobile or Work Phone: E-Mail:
Type of Residence:
House: Apartment: Condo: Mobile home:

Type and Height of Fence:
If renting: Landlord's name and phone or address:

Renters must provide proof pet is allowed, or HSCC must call and confirm

Interested in a featured adotable pet? Name(s):
Name of HSCC person you have talked with about this pet(s):
Pet Wanted:
Dog: Puppy 5-12 mo: Puppy 2-4 mo: Male: Female:

Breed, Color, Size, etc.
Household
Adults (Number): Children (ages): Dog: Cats: Other:

Does everyone in your household want a pet?

About how many hours per day is someone home?

Who will be the main caregiver?

What is your basic lifestyle? (Calm, busy, noisy, etc.)

Where will the pet spend most of its time?

Has anyone in your household had other pets?

If so, what kind and what happened to them?

Do you have, or will you immediately get, a pet carrier?

Can you afford proper care for a pet (good quality food, vaccinations, flea/tick preventive, de-worming, etc.)?

Your veterinarian's name and phone or address

If none, which vet do you plan to use?

References
Name and Phone or e-mail

Name and Phone or e-mail

I certify that all information is accurate. I understand that a contract and fee are required if adoption is approved.