Date / / Animal Name:
Adoption Application
801 Van Camp Road, Bowling Green, Ohio 43402
Phone: (419) 352-7339 Fax: (419) 352-2359
http://www.woodcountyhumanesociety.org
http://www.woodcountyhumanesociety.petfinder.com
Email:
We are excited that you are considering adopting an animal from the Wood County Humane Society (WCHS). Please carefully read, and complete the following application in full and honestly. Incomplete applications will delay processing. WCHS also wants the opportunity to best ensure you and your new pet will enjoy life together. Adopting an animal means making a commitment for the lifetime of the animal you choose. The adoption process is designed to help meet the best interests of the animals. Finding a pet that is compatible with your lifestyle and needs is also very important to the WCHS.
Adopter Information:
Full Name: ______Number of People in Household:______
Phone # Alternate # Best time to call:
Address: Email:
City: State: Zip: Driver’s License #
Describe your lifestyle (Library, Circus, etc.) ______
Reason for adopting (check all that apply):
ð Family companion ð Companion for other animal ð Guard/security/protection ðGift ð Hunting
ð Exercise buddy ð Breeding ð Mousing/barn animal ð Other
What are you most concerned about adopting a pet? ______
Do you currently: ð Rent ð Own ð Other
If you have a property manager please provide: Name of property:
Manager Name: Phone#
Have you ever adopted from WCHS? ð Yes ð No
Are you currently a student? ð Yes ð No
If yes, is your permanent home address different than listed above? ð Yes ð No
If yes, what is your permanent home address?
Address:
City: State: Zip:
Home Environment Information:
Your household consists of (check all that apply): ð Adults only ð Family with older children (10+ years)
ð Family with young children (younger than 10 years old) ð Seniors (60+) ð Live alone
The activity level in your home is: ð Quiet ð Active ð Hectic
What would you do with a pet you could no longer keep?
Time at home: ð Rarely (sleep there only) ð At home when not at work ð Home all day (someone is there)
How many hours per day will your pet spend alone? Weekdays Weekends
What type of sleeping arrangements are you able to provide for the animal you are interested in adopting?
______
Pet History:
Please check all that apply: ð First-time pet owner ð Had pets growing up ð Have pets now
Please list all domesticated animals you have owned in the past 5 years, include current animals.
Species/Breed Color Age/Sex Owned How Long Where is this animal now?
Veterinarian’s Name: Phone Number:
**WCHS reserves the right to contact your current veterinarian to verify care of present/past pets in my home.**
Pet Selection Preferences:
Training level (check all that apply): ð Fully trained ð Partially trained ð Not trained ð House trained
Activity level: ð Very Active ð Somewhat active ð Quiet ð No Preference
Please note any other desired traits here:
How will your pet get exercise/enrichment?
What behaviors do you believe you could manage on your own? Also, what are some that you would have difficult with managing on your own? ______
Typical adjustments period for a new animal in the home is usually 1-3 months, would that be a concern for you? If so, what could we do to help with this concern ______
How do you feel about declawing (if adopting a cat)?
*You will have some housetraining with your new pet as s/he adjusts to their new home. We suggest a regular feeding schedule as well as schedule of when your dog goes outside.
Have you ever surrendered a pet to a shelter/humane society? ð Yes ð No
If yes, please explain circumstances and when:
Adopting can be a commitment of 10 years or more. I am at least twenty-one (21) years of age, and I accept the responsibility of caring for a new animal, and agree that the answers provided on this questionnaire are honest and accurate. In signing below, I give WCHS permission to contact any references/veterinarians and verify any of the information I have provided.
Applicant Signature Date WCHS Authorized Witness Date
How did adopter hear about this animal (check all that apply): ð WCHS website ð Petfinder.com ð Friend ð Off Site Event ð Radio ð TV ð Vet ð Other:
Discuss (initial once discussed):
Meet your match Canine or Feline-ality.
Adjustment to new home.
Housetraining (housetraining log).
Best choice of toys, chew bones.
General training, obedience/behavior.
Introduction to existing pet(s) if adopter desires.
Medical/behavior issues (if applicable).
WCHS Staff Printed Name:
WCHS Staff Signature: Date: