Personal Information

First Name *

Last Name *

Date of Birth *

Street Address *

City *

State *

Zipcode *

How long have you lived at this address? *

Email Address *

Cell Phone *

Home Phone

Occupation *

Name of employer *

Why do you want to adopt this pet? *

Have you had pets in the past? *

Please list what species of pets you have previously had.

Do you have current pets? *

Please list all current pets in the household (names, species, ages, spayed/neutered).

Who will be responsible for this animal? Please choose all that apply. *

Are you a frequent traveler? *

Where will this animal stay while you're away?

Please list all occupants in your home. (Name, Age, and Relation to You) *

Do you rent your home? *

Do you have an HOA?

Please provide the name and phone number for your HOA.

Please provide you landlord's Name and Phone Number.

I agree, in accordance with the DCSPCA adoption contract, that if I cannot keep this animal for any reason, I will return the animal to the DCSPCA (I will not rehome or give away the animal without contacting the DCSPCA first). *

Where did you first hear about the animal you are applying to adopt? *

Animal Section

Please choose the correct animal and species to trigger the appropriate questions.

Select the animal you would like to adopt *

Species *

Is this a Working Cat? *

Would you consider adopting an animal with special needs? *

Please describe any experience you've had with special needs animals, if any.

How many hours per day will this dog be left alone? *

Where will this dog be when left alone? *

How do you plan to train this dog? *

Do you have or have you ever had a dog with behavioral problems? If yes, please describe. *

Do you acknowledge that it can take up to 2 months for a dog to adjust to a new home? *

Have you ever had a declawed cat? *

How many hours per day will this cat be left alone? *

When left alone, where will this cat be kept? *

This cat will be: Indoors, Outdoors or Both *

What is your plan to introduce this animal to other animals in your home? *

Do you acknowledge that it can take up to 3 months for a cat to adjust to a new home? *

What type of facility will this cat live in? *

If other, please explain. *

Address of facility (Street, City, State, Zip) *

Do you rent or own this facility? *

If rented, you agree to provide a letter from the landlord authorizing this adoption. *

Is the facility climate controlled? If yes, how? (Oil heat, A/C, etc.) *

Are their other animals in the facility? If so, what kind and how many? *

What is the distance of the facility from the road? *

Will someone be at the facility on a daily basis? *

Do you plan to declaw this working cat? *

Do you agree to provide a constant supply of food and water to this cat *

Do you agree to adhere to the DCSPCA's policy of a confined adjustment period for 1-2 weeks for this cat? *

Do you agree to provide veterinary care for this cat, including routine vaccinations? *

Do you agree to allow a DCSPCA staff member to inspect the facility prior to adoption? *

Where will this rabbit be housed? *

How many hours per day will this rabbit be left alone? *

When left alone, where will this rabbit be kept? *

If caged, how often do you plan to take this rabbit out for playtime and exercise? *

Do you acknowledge that it can take up to 3 months for an animal to adjust to a new home? *

Where will this chinchilla be housed *

How many hours per day will this chinchilla be left alone? *

Where will this ferret be housed? *

How many hours per day will this ferret be left alone? *

Where will this gerbil be housed? *

How many hours per day will this gerbil be left alone? *

Where will this guinea pig be housed? *

How many hours per day will this guinea pig be left alone? *

Where will this hamster be housed? *

How many hours per day will this hamster be left alone? *

Where will this mouse be housed? *

How many hours per day will this mouse be left alone? *

Where will this rat be housed? *

How many hours per day will this rat be left alone? *

Where did you hear about the animal you are applying to adopt? *

References and Disclaimers

Please provide a personal reference - NOT related to you. (Name, Phone #, Relationship) *

Please provide the Name and Phone # of your current Veterinarian. *

I have called my veterinarian's office and given authorization for them to speak with Dutchess County SPCA about my care of my pets. *

I understand that this application does not guarantee approval. Approval is contingent on the results of DCSPCA's review process. DCSPCA has the right to reject any application if it is considered not to be in the best interests of the animal. *

Please upload an image of the front of your driver license.

For the purpose of adopting, I certify that the above statements are true and complete. The DCSPCA retains the right to deny any adoption due to false information, or if the staff believes that it is in the best interest of the animal. *

Type your full name to electronically sign this document. *

Adoption Application

Personal Information

Animal Section

References and Disclaimers