First Name *
Middle name/initial *
Last Name *
Applicant's Date of Birth *
(Required for Background Check)
Driver's License / State ID number *
State of Issue *
Email *
Phone Number *
(no dashes just numbers)
Physical Address *
City *
State *
Zipcode *
Animal Application *
Please indicate the type of animal you are applying to adopt
Dog
Cat
Other
Animal Name *
Bear (Dog - 25-386)
Blaze (Cat - 25-393)
Curly Sue (Cat - 25-377)
Harley (Dog - 25-351)
Miku (Dog - 25-395)
Pearl (Cat - 25-319)
Ralph (Rat - 25-380)
Rita (Rat - 25-381)
Rowdy (Dog - 25-370)
Spongebob (Cat - 25-320)
Terry Ives (Dog - 25-373)
Waffles (Dog - 25-325)
Is your residence inside the City Limits of Gillette? *
No Yes
Is your residence still in Campbell County? *
No Yes
Since you indicated your residence is in Campbell County, do you have a fenced in yard/pen with dog shelter? *
Yes
No
The Campbell County Sheriff's Office requires a fenced in yard/area with shelter (or free access dog door) in order to adopt. If you do not have this criteria met your adoption will be denied. Contact the Campbell County Animal Control division at (307) 682-7271 for help with questions regarding their criteria.
Please describe your residence (house numbers, colors, gated entrance, etc) *
Please be as specific as possible about your property. This will help the Campbell County Sheriff's Office locate the correct property when they conduct their fence inspection
What type of fence/kennel do you have in place? *
Wood
Wire
Plastic
Metal
Other
Please describe what type of fence you have
How tall is your fence (in feet) *
List any adults in the household over the age of 18 *
(Include full name, date of birth, and phone number for each person. If you are the only adult put N/A).
Do you have permission form the current landlord/homeowner *
(if you are the homeowner indicate YES)
No Yes
You may not be approved to adopt a pet if your landlord does not allow you to have a dog/cat. Ensure you have permission before you attempt to adopt
How many dogs currently live in the household *
If you have none put '0'
For each dog in your residence, enter your dog(s) Name, Breed, Colors, Age, Sex, Altered status, Rabies Expiration date and Veterinary Clinic *
(Ex: Fido, Lab, Black, 1yr, Male, Neutered, Exp [date] at Veterinary Clinic)
How many cats currently live in the household *
(If you have none enter '0')
For each cat in your residence, enter your cat(s) Name, Breed, Colors, Age, Sex, Altered status, Rabies Expiration date and Veterinary Clinic *
(Ex: Fluffy, DSH, Orange, 1yr, Female, Spayed, Exp [date] at Veterinary Clinic)
I agree that this application is subject to review and does not reserve any animal for me until the application is approved and I have met in-person with the City of Gillette Animal Shelter to finalize the adoption *
Failure to agree will result in cancelled application
Yes No
Do you understand that any false information provided today will result in this application being denied and may affect future applications to adopt? *
Signature indicates you understand and agree that this information is accurate to the best of your knowledge
Clear
