Adoption Application

The Animal Shelter of Sullivan County Adoption Application

MUST SIGN HEREI understand the Animal Shelter of Sullivan County cannot guarantee that I'll receive this pet(s) or that this application will be approved. The Animal Shelter of Sullivan County reserve the right to refuse or deny any adoption application if it is not in the best interest of the animal. Incomplete Applications will not be processed.
Animal Interested in Adopting
First Name *
Last Name *
Address *
Apartment Number
City *
State *
Zipcode *
what county do you live in *
Phone Number *
E-mail Address *
Are you 21 years old or older *
Please upload a photo of your driver's license. * You may take a photo or scan of your drivers license and upload it here
How long have you lived at the above address? *
Do you plan to move in the near future? *
If you are planning on moving, when will you move?
What type of home do you live in? *
Do you? (Select all that apply) *
If renting, provide your landlord's name and phone number. Note if this is incomplete the application will not be processed. Landlord verification is mandatory.
Do you live with parents, roomates, spouse, etc? *
If you answered yes to the above question, do you have their permission to have a pet in the home?
Please list all members of your household. Include name, age, relationship. Additionally please provide phone numbers for any adults. *
Do you have children (under 18) who visit regularly? *
If yes to the above question, how old are the children?
Is anyone in the house allergic to animals? *
Type of animal allergy
Please rate your household's energy level (1 being like a library and 5 being like an amusement park) *
Employment information (select all that apply) *
What is your occupation?
How many hours will this pet be alone? *
If you do not have any form of income how will you provide for this animal?
Do you currently have other animals living in the home or have had any animal(s) in the past 5 years? *
If yes, please list each animals species, age, if they are spayed/neutered, live indoor/outdoor/both, if they have had their annual vaccinations, how long you have owned them, if you still own them or if they have passed away. Please complete the following for each animal! 1. Species: Cat, dog, other 2. Age 3. Spayed/ Neutered/ or unaltered 4. do they live Indoor/ Outdoors/ or both 5. Are their annual vaccinations up to date? 6. How long have you owned them? 7. Do you Still own them/ Do not still own/ or have they passed away?
If any of your animals are not yet spayed/neutered or up to date on vacccinations, please explain why.
Why do you want a new pet at this time? (Select all that apply) *
If this pet is a gift for someone else are they aware of this? Please list their name and phone number
Where will this per be primarily living? (select all that apply) *
If you are looking to adopt a cat, what will you plan to do for your new cat's scratching needs? (Select all that apply) Must answer for cat adoptions
If you are looking to adopt a dog, how do you plan to exercise them? (Select all that apply) Must answer for dog adoptions
Are you prepared to pay for vet bills when your new pet requires medical attention/ routine care (vaccines, surgeries, heartworm prevention, deworming medications, flea/tick medications, etc? *
What changes in your life or behaviors by your new pet would cause you to return them to the shelter? (Please note per your contract you MUST return any animal adopted directly to the shelter. You may NOT rehome them on your own) Select all that apply *
Do you have a current veterinarian? *
Please list your Veterinary clinic name and phone number must answer if providing a vet reference
What person's name will the veterinary record be under?
May we contact your veterinarian regarding your application and to send any new pet information to their clinic?
I hereby certify that the above information I provided is true to the best of my knowledge. I give permission for any of this information to be verified. I understand that filling out an application does not guarantee or entitle me to adopt an animal, animals are not held or reserved. I understand that animals will be adopted to the best possible match presented in the order the applications are received, processed, approved, meet/greets and any home checks are completed. *
Date of signature *

Together we can do great things for the homeless animals of Sullivan County