Adoption Application

HUMANE SOCIETY OF UNION COUNTY ADOPTION APPLICATION
This Questionnaire will help you think about how a rescued pet might impact your life. A pet is a commitment of 10-20+ years; please give pet ownership serious consideration before deciding to welcome any animal into your home. Incomplete applications will not be considered.
I have read the above statement
- Yes
Date
ADOPTION PET INFORMATION
Are you interested in a dog or cat?
- Dog
- Cat
Name of dog or cat
YOUR INFORMATION
Your name*
First Last
Street Address*
Street Address Address Line 2 City State ZIP Code

(No PO Boxes)
Best Contact Phone*
Email*
Age*
Employment*
- Employed Full time
- Employed Part time
- Self-Employed
- Not Employed
- Homemaker
- Retired
- Student
Name of employer
Marital Status
- Married
- Single
- Divorced/Widowed
SPOUSE OR SIGNIFICANT OTHER'S INFORMATION
Name of Spouse or Significant other
First Last
Age of spouse/significant other (If applicable)
Employment status of spouse/significant other
- Employed Full time
- Employed Part time
- Self-Employed
- Not Employed
- Homemaker
- Retired
- Student
Name of spouse’s employer
LIVING SITUATION
Please list any children who live in your home and their ages
(If applicable)
Does anyone else live in your home?*
- Yes
- No
Names and ages of anyone else living in your home
Does anyone in your home suffer from allergies/asthma*
- Yes
- No
What best describes your living situation?*
- Own a home
- Own condo/townhome
- Rent a home
- Rent Apartment/condo
How long have you lived at this address?
If less than 2 years, previous address and landlord
Do you have a fully fenced yard?*
- Yes
- No
On a Typical day, your pet will be alone*
- Fewer than 4 hours
- 4-6 hours
- More than 8 hours
What do you expect the monthly expenses to be for your new pet?*
- $50 or less
- $50-100
- More than $100
Who will be the pet’s primary caretaker?*
Where will you keep your pet during the day?*
Where will the pet sleep at night?*
What is your plan for training your new pet?*
HISTORY OF PET OWNERSHIP
Have you ever taken a pet to a shelter, sold a pet, or found a new home for one?
- Yes
- No
If yes, please explain
Do you currently own any pets?*
- Yes
- No
If yes, please provide us with the following information for each dog/cat: Breed/Size, Age, Male or Female, Indoor/Outdoor/Both, Spayed or Neutered? Current on heartworm prevention? Friendly to other dogs, cats, people?
Please list any pets that have died in the last 5 years and cause of death
VETERINARY INFORMATION
If you do not currently see a veterinarian, please give us the practice you plan to use when you adopt. Please notify your veterinarian's office that the Humane Society of Union County will be in contact with them to release information.
Clinic name*
Clinic phone number*
Veterinarian’s name
First Last
PERSONAL REFERENCES
Name and contact numbers for personal references not related to you
Full name (reference #1)
First Last
Phone number
Full name (reference #2)
First Last
Phone number
OTHER
Any additional comments or questions you would like to share with our adoption team