Adoption Application

GREENSBURG DECATUR COUNTY ANIMAL SHELTER 1635 W Park Rd Greensburg IN 47240 * 812-663-9081
Animal you are interested in adopting *
Applicant's First Name *
Applicant's Last Name *
Street Address *
City *
State *
Apartment Number (if applicable)
Zip Code *
Email Address Please enter correctly as this is the main way we will contact you
Alternate Phone Number *
Do you understand that GDCAS makes no guarantee of the health of this pet and that veterinarian expenses be incurred after adoption they will be your responsibility? *
Is this pet for you or someone else? *
Do you own other pets at the current time? *
If yes, please list their names, breeds, and ages. *
Are all of your pets spayed/neutered/fixed? *
Are your pets current on their vaccinations? *
Have you surrendered an animal to GDCAS in the last year? *
If yes, please explain?
Veterinarian's Name * If you have never owned a pet please tell us where you would go.
Veterinarian's Address, City, State, and Zip Code Again if you have never owned a pet please list where you would go
Veterinarian's Phone Number
How do you feel about having pets spayed/neutered?
If you have pets, will they adjust to a new pet in the house?
Please check the main reason you plan to adopt a pet:
If you answered "other" above, please explain here:
Do you own or rent your home?
Please select your current residence type.
If you answered "other" above, please explain here:
If you rent, does your landlord and lease allow pets?
Please list your landlord's name and phone number
Including yourself, how many people live in your household?
Please list the ages & relationship of those who live in your home.
Is everyone in your household aware that you are planning to adopt a pet?
Does anyone in your household have allergies to dogs/cats?
Employment Status *
If you chose "other" above, please explain:
If you are employed, what is your current occupation?
On average, how many hours per day will your pet be left alone? *
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 "other" above, please explain:
If you do not have a fenced yard, how will you let the animal out?
Where will the animal sleep?
If you answered "other" above, please explain:
How will you handle housebreaking?
How will you handle destructive behavior?
Have you ever been convicted of abuse or neglect of a child or animal? *
If yes, please explain:
What will you do with the animal when you go on vacation?
If you answered "other" above, please explain:
For what reason(s) would you consider returning/giving up the animal? *
What would you do with your animal if you had to move? *
If you answered "other" above, please explain:
Are you willing to take responsibility for this animal for the next 10-20 years?
How did you hear about this animal? *
If no, please explain:
Photo ID * Please attach a photo of your Driver's License
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. I understand that this contract is not binding and is not a guarantee of adoption. Adoptions are still done on a first come, first serve basis.
Please initial to complete your application *

Adoption Application

GREENSBURG DECATUR COUNTY ANIMAL SHELTER

1635 W Park Rd Greensburg IN 47240 * 812-663-9081