FCHS Adoption Application & Contract
Interested in adopting a:
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Cat|Dog|Other
Cat
Dog
Other
Who are you interested in adopting?
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Flower (Cat - O2024767)
Huey (Cat - S20241340)
LM 08/Heaven (Cat - O2024732)
LM 11/Lady (Cat - O2024735)
LM 14/Liko (Cat - O2024738)
Missy (Cat - O2022709)
Ollie (Cat - S20232822)
Panda (Cat - O2023768)
Panther (Cat - O2024768)
Penelope (Cat - O2024746)
Poppy (Cat - S20241426)
Smooty/Oden (Cat - S20211323)
Who are you interested in adopting?
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Amelia (Dog - O2023763)
Arya (Dog - S20241404)
Ash (Dog - S20241363)
Block (Dog - S20232668)
Bodhi Hudson/Dash (Dog - S2024031)
Cooper (Dog - S2019964)
Crimson (Dog - S20241383)
Diesel (Dog - O2018528)
Ferguson (Dog - S20241393)
Fern (Dog - S20241405)
Fiddle (Dog - S20232829)
Gunner (Dog - S20241378)
Hannah (Dog - S20232492)
Houdini (Dog - S20241395)
Hurley (Dog - S2024025)
Izzy/Reeva (Dog - S20232261)
J49/Janie (Dog - C2022017)
Jasper (Dog - S2024027)
Legacy (Dog - S20232282)
Lewis (Dog - S20241414)
Lilo (Dog - S20241410)
Maxwell (Dog - S20241411)
May May (Dog - S20232403)
Mozart (Dog - S20241401)
Nash (Dog - O2023868)
Nevaeh (Dog - A2023016)
Ringo/Snoop (Dog - S20241387)
Tank/Beau Watkins (Dog - S20221930)
Taz (Dog - A2023015)
Who are you interested in adopting?
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Applicant's First Name
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Applicant's Last Name
*
Street Address
*
City
*
State
*
Zip Code
*
Phone Number
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Please use the following format 555-555-5555
Alternate Phone Number
Please use the following format 555-555-5555
Email Address
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Are you 18 years or older?
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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:
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Other
House
Apartment
Condo
Mobile Home
If you answered "Other" then please explain here.
Is your residence a rental property?
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No
Yes
Landlord's Name
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Landlord's Phone Number
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Will the pet live:
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Indoor and Outdoor
Indoor Only
Outdoor Only
Will the dog be chained or penned?
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No
Yes
If chained or penned then how long each day?
Do you have a completely fenced yard?
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No
Yes
If yes, what type and height?
On average, how many hours per day will your pet be left alone?
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Please list the ages & relationships of people living in your home.
*
Do you own other pets at the current time?
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No
Yes
If yes, please list their names, gender, breeds, and ages.
Are all of your pets spayed/neutered?
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No
Yes
If no, which ones?
Veterinarian's Name
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Veterinarian's Phone Number
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Please use the following 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?
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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?
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No
Yes
Are you prepared to care for this pet for the rest of its natural life?
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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.
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No
Yes