Dog Adoption Application - Animal Friends of Barbour County, Inc.

Name

First Name

Last Name

Street Address

City

State

Zip Code

Primary Phone Number

Alternate Phone Number

Email Address

What is your age?

Under Age 18

18 or Older

How many children live in your household?

What is the age of each child?

Check your status:

Employed

Retired

Student

Unemployed

If employed, please provide your employer's name.

What is the name of the shelter pet you would like to adopt?

Is this pet a cat or a dog?

Cat

Dog

Other

What is the pet's breed?

For whom are you adopting this pet?

Myself

My Family

Friend/Relative

If pet is for a gift, does the recipient know they are getting a pet?

Yes, they know I am giving them a pet.

No, this pet is a surprise gift.

What steps will you take to resolve any disciplinary or behavioral problems should they arise?

Are you or any members of your household allergic to animals?

Yes

If yes, please state who has allergies and to what animals.

Do you currently have pets?

Yes

If yes, please list what kind and how many pets you have.

If you currently have pets, are their vaccinations up-to-date?

Yes

Do you have current licenses for dogs you own?

Yes

Do you usually have your pets spayed or neutered?

Yes

Please give us a veterinary reference. Include the name of your vet, the vet office phone number and the name of your pet that's been treated at that office.

Name and Phone Number of Your Veteranian

Do you own or rent your home?

Own

Rent

If you rent, does you have your landlord's permission to have a pet in your home?

Yes

Do you have a fenced yard?

Yes

Where will this pet be kept?

ALL pets adopted from Animal Friends must be spayed or neutered.

I understand and agree to spay/neuter any pet I adopt from Animal Friends.

TERMS AND CONDITIONS
I have read the above information carefully and have filled out this application honestly. I understand that omission and/or failure to truthfully answer the questions can result in the application being declined. Also, if an omission or untruth is discovered after the adoption takes place, I understand that Animal Friends of Barbour County reserves the right to annul this Adoption Contract and reclaim the animal. I give Animal Friends of Barbour County permission to fully investigate the information I have provided, as well as contact the veterinarian I listed. If this application passes review, I would agree to a home visit on a mutually agreed upon date by a representative of Animal Friends of Barbour County, if requested.

I Understand and Agree to the Above Terms and Conditions

Ask any questions or request more information in this textbox. Please be brief.

If you are human, leave this field blank.

Adoption Application - DOGS