Adoption Application HSCCL

Applicant's First Name *
Applicant's Last Name *
Home Phone Please use the following format 248-555-1212
Cell Phone *
Email Address * Please enter carefully as this is the main way we will contact you
What is the best way to contact you?
Street Address *
Apartment Number (if applicable)
City *
State *
Zip Code *
Are you over 18 years of age?
Drivers License Number *
If you have a specific animal you are interested in adopting, please select them from the list
List any other pets you're interested in meeting
If you haven't selected a pet from our Adoptable Pets page, what type of pet are you looking for?
If you have a breed in mind please list. Keep in mind most of our pets will be a mix of breeds
Are you looking for a male or female?
What age range(s) are you considering
What activity level are you considering? Check all that apply
Do you own other animals? *
If you own other animals, are you willing to bring them to a meet and greet before adopting?
We do adoptions by appointment only. We are closed on Sundays and Mondays. Please choose a day that you would be available for an appointment. *
If you rent, does your landlord and lease allow pets?
Will this pet be predominantly living inside, outside, or both?
Do you have a completely fenced-in yard? If so, what kind of fence?
If you answered "no fence" or "other" above, please explain:
Have you ever turned your dog or cat into a shelter?
If yes, please explain?
Have you ever had a pet euthanized?
If yes, please explain:
Have you ever been convicted of abuse or neglect of a child or animal?
If yes, please explain:
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. *