FCHS Adoption Application & Contract
Interested in adopting a:
*
Cat
Dog
Other
Who are you interested in adopting?
*
Aslan (Cat - S2025304)
Ayla (Cat - S2025305)
Barb (Cat - S2025225)
Bramble (Cat - S2025301)
Callum (Cat - S2025287)
Campbell (Cat - S2025122)
Cashew (Cat - S2025121)
Chonk D (Cat - O2024886)
Dale (Cat - S2025298)
Delma Mom (Cat - S2025255)
Freesia (Cat - S2025269)
Hedger (Cat - S2025285)
Hivey (Cat - S2025281)
Holden (Cat - S2025282)
Huck (Cat - S2025284)
Hugo (Cat - S2025283)
Ila (Cat - O20251025)
Ireland (Cat - S2025145)
Italy (Cat - S2025146)
Jacinta (Cat - S2025268)
Justice Mom (Cat - S2025288)
Luna Newby/Yana (Cat - S20232454)
Lyla Mom (Cat - S2025307)
Macaroni (Cat - O2025996)
Marcie Mom (Cat - O2025995)
May (Cat - S2025213)
Mittens (Cat - O20251014)
Narnia (Cat - S2025303)
Nastya (Cat - S2025187)
O Momma/Candy (Cat - O20251001)
Panda (Cat - O2023768)
Penny Mom (Cat - S2025192)
Puffy (Cat - A2025006)
Queen Mom (Cat - S2025200)
River Mom (Cat - S2025203)
Rosea (Cat - S2025286)
Sherbert (Cat - S2025295)
Sorrell (Cat - A2025005)
Tolli Mom (Cat - S2025215)
Trigger (Cat - O2019097)
Twinsie Mom (Cat - S2025214)
Unity Mom (Cat - S2025230)
Yabrina (Cat - S2025316)
Yarely (Cat - S2025266)
Yosemite (Cat - S2025180)
Zilly (Cat - S2025253)
Who are you interested in adopting?
*
Ash (Dog - O2025990)
Brehme (Dog - S2025034)
Bruno (Dog - O2025992)
Calloway (Dog - S2025241)
Carlos/Carl (Dog - S20221887)
Chip (Dog - S2025245)
Coco Woods/Honey (Dog - S2025273)
Copper (Dog - O20251017)
Donnie (Dog - S2025126)
Fiddle (Dog - S2025153)
Fluffy (Dog - S2025228)
Harley (Dog - O2025965)
Harper Woods (Dog - S2025274)
Houdini (Dog - S20241395)
Lydia (Dog - S2025156)
MJ Coleman/Sugar/Mabelline (Dog - S2025306)
Mark (Dog - S2025127)
Marley/Valley (Dog - S2025026)
Miley (Dog - S2025302)
Miller (Dog - S2024009)
Moana (Dog - S2025263)
Odell (Dog - S2025311)
Pansy (Dog - O2025979)
Penelope (Dog - S2025237)
Sir Wellington (Dog - S2025199)
Skittle (Dog - S2025152)
Sosa (Dog - S2025107)
Star (Dog - O2025937)
Willow (Dog - O2025991)
Who are you interested in adopting?
*
Applicant's First Name
*
Applicant's Last Name
*
Street Address
*
City
*
State
*
Zip Code
*
Phone Number
*
(Format 555-555-5555)
Alternate Phone Number
(Format 555-555-5555)
Email Address
*
Confirm email
Are you 18 years or older?
*
If you are under 18 years old, please have a parent or guardian to submit the adoption application with their information.
No
Yes
Please enter your birthdate.
*
Do you live in a:
*
Other
House
Apartment
Condo
Mobile Home
If you answered "Other" then please explain here.
Is your residence a rental property?
*
No
Yes
Landlord's Name
*
Landlord's Phone Number
*
Will the pet live:
*
Indoor and Outdoor
Indoor Only
Outdoor Only
Will the dog be chained or penned?
*
No
Yes
If chained or penned then how long each day?
Do you have a completely fenced yard?
*
No
Yes
If yes, what type and height?
On average, how many hours per day will your pet be left alone?
*
Please list the ages & relationships of people living in your home.
*
Do you own other pets at the current time?
*
No
Yes
If yes, please list their names, gender, breeds, and ages.
Are all of your pets spayed/neutered?
*
No
Yes
If no, which ones?
Veterinarian's Name
Veterinarian's Phone Number
(Format 555-555-5555)
Since most shelter animals have unknown backgrounds, are you prepared to take your pet for a complete physical within 72 hours of adoption & provide necessary medical treatment?
*
No
Yes
Are you aware that the average pet costs in excess of $500 per year in just food and medical care, and that the average life span is 15 years?
*
No
Yes
Are you prepared to care for this pet for the rest of its natural life?
*
No
Yes
The answers I have given are complete, true and not misleading in any way. I am authorizing FCHS to contact my landlord and veterinarians. I am aware that FCHS cannot guarantee the health and temperament of the animal. If I can no longer keep this animal I agree to return it to FCHS. By selecting Yes and clicking Submit I am agreeing to this contract agreement.
*
No
Yes