Adoption Application

**Must be a minimum of 18 years old to adopt**

First name *

Last name *

Date of birth *

Address *

City *

State *

Zip *

Email *

Cell phone *

Home phone *

Please provide your veterinarian contact information *

Do you have any children in the home? *

If you rent, please provide your landlord's contact information *

Please describe the ideal pet for your home. *

How would you describe your household? *

Please tell us about the other dogs and cats currently living in your home. Please include name, pet type, age, spayed/neutered, behaviors etc.. *

What would your ideal pet be? Please describe any details you are looking for. Would you prefer a calm or energetic pet, young or adult, good with cats, good with other dogs, good with kids, good with traveling, etc? This is to attempt to match you with the ideal animal for you and your needs, please be detailed about what you are looking for. *

I understand that:

Adopting a pet is a long term commitment
The Community Humane Shelter of Steuben County reserves the right to refuse/reject any application at its discretion
My electronic signature allows release of any information necessary to process this application
The Community Humane Shelter of Steuben County may perform a criminal background check as part of the application process.

Signature of applicant *