FCHS Adoption Application & Contract
Interested in adopting a:
*
Cat
Dog
Other
Who are you interested in adopting?
*
Axel (Cat - S20211292)
Bartley (Cat - S20243232)
Binx Pierce (Cat - Q2024007)
Biscotti (Cat - S20243205)
Blair (Cat - S2025003)
Bobbi (Cat - S2025058)
Bon-Bon (Cat - S2025029)
Brenden (Cat - S2025022)
Britches (Cat - O2025935)
Catherine (Cat - O2023826)
Conner (Cat - S20243121)
Cupid (Cat - S2025028)
Fancy (Cat - S20243062)
Figgy (Cat - S20243045)
Goldie Edwards (Cat - P2024019)
Hallie Mom (Cat - S20232648)
Harlee Momma (Cat - S20241555)
Hazel M (Cat - O2024891)
Kip (Cat - S20243017)
Kiwi Mom (Cat - O2024778)
LaRoy (Cat - S20243161)
Love Momma (Cat - S20241597)
Meadow (Cat - S20242923)
Nadia (Cat - S2025010)
Omega (Cat - O2016333)
Opal/Kambri (Cat - S2019080)
P06 Tony (Cat - O2024753)
Panda (Cat - O2023768)
Pixie (Cat - S2025046)
Ronan (Cat - S20243028)
Rosetta (Cat - S2025051)
Rosko (Cat - S2025038)
September Momma (Cat - S20243029)
Socks (Cat - O2024890)
Soloman (Cat - S2025056)
Sweater (Cat - S20243030)
Toni (Cat - O2025934)
Truffles (Cat - S2017573)
Virgo (Cat - S20243066)
Willa Mom (Cat - S20232616)
Willow (Cat - A2024012)
Who are you interested in adopting?
*
Annie (Dog - S20232445)
Apple Dumpling (Dog - S20243206)
Bizzy (Dog - S2025025)
Brehme (Dog - S2025034)
Brewster (Dog - S2025043)
Buddy McCord/Mayor (Dog - S20243048)
Courty (Dog - S2025057)
Demaree (Dog - T2025004)
Diego (Dog - S2025032)
Diesel Tincher/Dax (Dog - T2024007)
Elena Phibbs (Dog - T2024001)
Fender (Dog - S20242986)
Furby (Dog - S2025045)
Gelato McCaskell (Dog - C2024007)
Glory (Dog - S2025059)
Hercules (Dog - A2024010)
Houdini (Dog - S20241395)
Kirby (Dog - S2025044)
Lennon (Dog - S2025041)
Logan (Dog - S20243078)
Lola/Denali (Dog - S2025024)
Lotus (Dog - S20232477)
Luna/Millie 5/Mulan (Dog - P2024005)
Manny (Dog - S2025031)
Marigold (Dog - S2025033)
Marnie (Dog - S20242996)
Merlin (Dog - S20242998)
Miles/Arthur (Dog - O2025933)
Milton (Dog - S20242997)
Nyla (Dog - S2025050)
Raisin (Dog - S20243185)
Rebel Tincher/Pollo (Dog - T2024006)
Star Phibbs (Dog - T2024002)
Sushi McCord/Warden (Dog - S20243049)
T-Bone Dunaway/Toby (Dog - P2025003)
Titan (Dog - S20241625)
Tonka (Dog - S20232699)
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
*
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