Macon County Animal Control Adoption Application

Name of Pet You Wish to Adopt *
Applicant's First Name *
Applicant's Last Name *
Street Address *
City *
State *
Apartment Number (if applicable)
Zip Code *
Phone Number * Please use the following format 248-555-1212
Alternate Phone Number
Email Address Please enter correctly as this is the main way we will contact you
How did you find out about us?
Do you currently own any pets? If Yes, how many? Please list whether they are dog, cat, etc. *
Are all of your pets spayed/neutered/fixed? *
Are your pets current on their vaccinations? *
Veterinarian's Name, Address and Phone Number * Again if you have never owned a pet please list where you would go.
Do you own or rent your home? *
If you have pets, will they adjust to a new pet in the house? *
Have you ever surrendered a pet to any animal shelter? If Yes, please explain. *
If you rent, please provide landlord's name and phone number. *
Do you have children? If Yes, please list their ages. *
Do you have a fenced-in yard? If no fenced in yard, how will you contain the animal to your property. *
Will the pet be living predominately inside, outside, or both? If outside, please explain set up for living. *
Will you keep the animal up-to-date on vaccinations and heartworm preventative? *
Have you ever been convicted of abuse or neglect of a child or animal? *
Are you willing to take responsibility for this animal for the next 10-20 years? *
*	I understand Macon County Animal Control will check my references.
*	I verify all of the above information is true and accurate to my knowledge.
*	I understand that Macon County Animal Control will disclose any of the pet's health or behavior issues if known before adoption.
*	I understand that this application is not an approval. If approved, Macon County Animal Control will contact me by phone or email to schedule a meet and greet with the potential pet.
Applicant's Signature *
Date *