Camden County Animal Shelter Pre-adoption Application

Species______Breed______Case #______Date______

-  Adopting a pet is a lifetime commitment. Dogs live an average of 12 to 15 years; cats 13 to 17.

-  We do not adopt pets to live outside full-time, especially to be tied/left out overnight.

-  All adopted cats/dogs must be spayed/neutered.

Our organization prides itself on successful adoptions. Your response to this application will aid us in this endeavor. This form also enables our staff to assist you with choosing a pet that is compatible with your lifestyle.

To be considered for adoption you must:

-  Provide a valid driver’s license or state ID, and be over the age of 21.

-  Show proof of your current address; supply written/verbal permission from your landlord if applicable.

-  Demonstrate the ability to provide a stable home, a safe environment, necessary veterinary care and nutrition, basic training, identification and companionship for the animal.

-  You must take the adopted animal to the veterinarian within seven days of adoption.

-  No refunds for adopted pets unless the pet has a severe previously unknown health issue.

-  If you must give up the pet, you promise to return the pet to Camden County Animal Shelter and pay all related fees.

Desired pick up date: ______

Last Name: ______First Name: ______

Address:______City: ______State: ______Zip:______

Home Phone: ______Cell Phone: ______

Place of Employment: ______Work Phone: ______

Email ______

1a. Do you: Own your home Rent your home 1b. Is it a: House Apartment Other

2a. Length of residency: ______2b. Landlord Name/Phone: ______

3a. Is this your first experience with a dog? Y N 3b. With a cat? Y N

4. Please circle the reasons you want to adopt:

Companion Guard dog Breeding Family Pet Business Gift Hunting

5a. How many people live in your home? ______5b. Do children under 18 live there? Y N

6. If yes, list their ages and if they are there full or part time______

7a. Do you have a fenced in yard? Y N 7b. If yes, fence height ______

8. Do you plan to use any of the following: Outside kennel Runner Chain Tie Line Dog House

9. Where will the pet sleep? ______

10. How many hours per day will the animal be without human companionship? ______

11. If adopting a cat/kitten, will it be allowed outside? Y N

12. If adopting a cat/kitten, do you plan on declawing? Y N

13. If adopting a dog, are you aware that it might require housebreaking? Y N

14. Are you aware it is mandatory for the adopted pet to be spayed/neutered? Y N

15. Do you agree to a pre-adoption and post-adoption yard/home check? Y N

16a. Do you have now, or did you recently have other pets? Y N 16b. If yes, please list below:

Species
(Cat or Dog) / Breed / Name / Age/
Sex / Fixed / Declawed / Current Shots
Y N / Y N / Y N
Y N / Y N / Y N
Y N / Y N / Y N
Y N / Y N / Y N

17a. Do you have now, or did you have in the recent past, a veterinarian? Y N

17b. If yes, list vet’s name and phone number: ______

18. If you have had pets in the recent past, state where they are now and what happened to them:

19. If you do not have a vet reference, please list the names/numbers of 2 personal references that can describe your experience with pets:

Name: ______Phone: ______

Name: ______Phone: ______

I certify that all of the above information is true. I hereby authorize release/disclosure of any records and/or other pertinent information including employment verification, proof of tenancy, and veterinary/personal references. I understand that any false information given on this application will automatically disqualify me from adopting from this shelter. The shelter reserves the right to deny any application it deems unsatisfactory.

Signature: ______Date: ______

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How did you hear about us?

Adoption Event/Fundraiser______Brochure/Flyer

Internet______Family or Friend

Media______Returning Customer

Other______Just Walked in

FOR OFFICE USE ONLY

-  Provided brochure ___

-  Put green slip on animal’s cage ____

-  Application taken by______

-  Dog meet required: Y N If yes, dog meet outcome: ______

-  Verified residence information: Y N

-  If applicant lives with family members, permission from family for pet: ______

-  Reference check completed: Y N