Adoption Application
PUBLIC ANIMAL WELFARE SERVICES
Applicant's First Name
*
Applicant's Last Name
*
Street Address and Apt. #
*
City
*
State
*
GA
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
Phone Number
*
Please use the following format 248-555-1212
Email Address
*
Please enter correctly as this is the main way we will contact you
Driver's License Number
*
Select Choose File and Take Picture of your Driver’s License
*
Who are you interested in adopting
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ARMANI (Cat - 241096ST)
Anchovy (Cat - 241131SU)
Athena (Cat - 24800SU)
BARRETT (Dog - 24943AC)
BAYLOR (Dog - 24938AC)
BEAU (Dog - 24937AC)
BECKETT (Dog - 24942AC)
BEHR (Dog - 24844ST)
BENTLEY (Dog - 24940AC)
BERRYHILL (Dog - 24820ST)
BLAKELEY (Dog - 24939AC)
BRASSY (Cat - 241097ST)
BROWNIE (Dog - 24850ST)
BTV 3 (Dog - 24654ST)
BTV 6 (Dog - 24657ST)
Babbles (Cat - 241147ST)
Baby (Cat - 24803SU)
Berry Dogg (Dog - 24903ST)
Betty (Dog - 24991SU)
Big Blue (Dog - 24913SU)
Block head (Dog - 24916ST)
Blossom (Dog - 24652ST)
Boss Man (Dog - 241067ST)
Brody/Rascal (Dog - 24565ST)
Bully (Dog - 24611ST)
CADE (Cat - 24500SU)
CAMERON (Cat - 24501SU)
CHLOE (Dog - 24846ST)
CORVIS (Cat - 24502SU)
CV2 (Cat - 24870CR)
CV4/Axl (Cat - 24872CR)
CV5/Bruno (Cat - 24873CR)
CV9M (Cat - 24877CR)
Connie (Dog - 24567ST)
Cuffs (Dog - 24904ST)
DIOR (Cat - 241111ST)
Darla (Dog - 24921ST)
Dude (Dog - 24984ST)
EGGROLL (Cat - 241071ST)
Eagle mama / Sierra/Ciara (Dog - 24683ST)
Eagle puppy / Sedona (Dog - 24684ST)
FLOPSY (Cat - 24777ST)
FUZZY (Dog - 24842ST)
Francis (Dog - 24762ST)
GLENDA (Dog - 24918ST)
GLORIANNA (Cat - 24571SU)
HATFIELD (Dog - 24824ST)
HAZEL PUP 6/CANDY CORN (Dog - 231663ST)
HUFFY (Dog - 24819ST)
Ireland 13/ Aoife (Dog - 24200ST)
KILEY (Dog - 241028ST)
Kay (Dog - 24992SU)
Kira Kat (Cat - 24438SU)
Kitten 2/LUNA LOVEGOOD (Cat - 24932SU)
Kitten 3 (Cat - 24933SU)
Kitten 4 (Cat - 24934SU)
LAKE (Cat - 241153ST)
Lake Ridge 2/RIHANNA (Dog - 24737ST)
Lake Ridge 6/ARIANA (Dog - 24741ST)
Leonardo Dicatrio (Cat - 24573SU)
Life puppy 2/DAENERYS (Dog - 24527ST)
Life puppy 4/ROBB (Dog - 24529ST)
Life puppy 7/JON SNOW (Dog - 24532ST)
MIDWAY (Dog - 24821ST)
MILEY (Dog - 241027ST)
MISS PIGGY (Dog - 24712ST)
Maggie (Dog - 24778ST)
Mikael (Cat - 24802SU)
Millie (Dog - 24629ST)
Mom Cat (Cat - 241051ST)
Oleary (Dog - 24161ST)
Overlook Mama/ODESSA (Dog - 24854ST)
Overlook pup 2/OTTO (Dog - 24856ST)
Overlook pup 3/OAKLEY (Dog - 24857ST)
Overlook pup 5/OPHELIA (Dog - 24859ST)
Patches (Cat - 241060SU)
R2D2 (Dog - 24274ST)
RAIN (Dog - 24767ST)
RF 1/ Daisy (Dog - 24839ST)
RF 2 / Dottie (Dog - 24840ST)
ROBIN HOOD (Dog - 241038ST)
ROSCOE (Dog - 24770ST)
Roman/BIG BOY (Cat - 24588SU)
Roxxy (Dog - 241106SU)
SASSY (Cat - 241099ST)
SHANNON (Dog - 24825ST)
SPHINX (Cat - 241055ST)
SPRING (Dog - 24822ST)
STEALTHY (Dog - 231722ST)
SUZEY (Dog - 24847ST)
Six (Dog - 24990SU)
TRIXIE (Dog - 24628ST)
Tabby Cat (Cat - 24583ST)
Tabby Tabberson (Cat - 24338ST)
Tally (Dog - 24443ST)
UTAH (Dog - 24618ST)
Verbena (Dog - 24551ST)
WUZZY (Dog - 24843ST)
Whoop-whoop (Dog - 2418ST)
Xfinity (Cat - 241123ST)
Zina (Dog - 24801ST)
Zues (Cat - 24801SU)
Do you Own or Rent?
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Own
Rent
Have you or someone in your household ever been issued a citation for your pet(s) or had to reclaim your pet from an animal control or shelter?
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I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal.
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Yes
No
Signature
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Clear