Adoption Application

*MUST SIGN HERE*I understand the Animal Shelter of Sullivan County cannot guarantee that I'll receive this pet(s) or that this application will be approved. 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. *

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.

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.

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

Who will br primarily responsible for the new pet's care? (Name) *

Are you committed to providing a permanent home for the lifetime of this new pet, which could be up to 15 or more years? *

Some pets take longer to adjust to their new home. Some adjust right away. Others may take up to two weeks to fully adjust or decompress after being in the shelter. This may be especially true if other animals are in the home.Are you willing to give your new pet the appropriate amount off time to decompress/ adjust? *

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)

If you are looking to adopt a dog, how do you plan to exercise them? (Select all that apply)

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? *

Behavior problems can arise for many reasons; most can be resolved. Do you agree to seek professional help and assistance to resolve these issues rather than simply return the pet should problems arise? *

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

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 *