Adoption Application

Thank you for your interest in adoption! Providing clear, thoughtful, and honest answers on this application helps us get to know you, your lifestyle, and your expectations. This allows us to make the best possible match between you and a pet whose needs align with your home—setting both of you up for a happy, successful future together.

I/We are looking to adopt a: *

Animal name (if known):

What made you decide to apply for this animal? If you are not applying for a specific animal, please tell us about why you are looking to adopt? *

Primary Adopter's First Name *

Primary Adopter's Last Name *

Street Address *

City *

State *

Apartment Number (if applicable)

Zip Code *

Phone Number *

Email Address *

Primary Adopter's Date of Birth *

Drivers License/State Issued Identification Number *

Is there a secondary adult adopter or co-applicant living in the home who will share responsibility for this animal and/or planning to meet the animal prior to adoption? *

Secondary Adopter's First Name *

Secondary Adopter's Last Name *

Secondary Adopter's Phone Number

Secondary Adopter's Email Address

Secondary Adopter's Date of Birth *

Including yourself, how many people live in your household? *

Please list the ages & relationship of those who live in your home. *

Please list the full name and date of birth of any additional adults living in your household

Does anyone in your household have a history of any violent behavior, including abuse or neglect of a child, adult, or animal? *

Are you adopting this pet for you or someone else? *

Employment Status *

If you chose "other" above, please explain:

I/We Live in a : *

Do you own or rent your home? *

If you rent, does your landlord and lease allow pets?

How many pets have you owned in the last 5-10 years? *

What happened to them? *

Do you currently have any other pets? *

If yes, please list their names, breeds, and ages.

Are all of your pets spayed/neutered/fixed? *

Are your pets current on their vaccinations? *

Do you have a regular veterinarian? *

Veterinarian's Name *

What are you looking for in a pet, and how do you envision them fitting into your daily life? To help ensure a great match, please be as detailed as possible when describing traits such as energy level, temperament, age, size, activity needs, and personality, as well as the type of companionship and interaction you hope to have. *

Have you ever rehomed or surrendered a pet? *

If yes, please explain the circumstances. *

Is there anything you’re unsure about or would like to talk through with us? *

How much do you expect to spend yearly for the care of your pet, including food, grooming, routine veterinary care, and unexpected medical expenses? *

Where will your pet spend most of their time? *

About how long would your pet be alone each day? *

Where will your new pet be kept while home alone? *

What is your plan for keeping your pet safe while outdoors? *

For what reason(s) would you return/give up your new pet? *

If adopting a cat, do you plan to declaw? *

How does housetraining fit into your expectations for a new pet, and what approach would you take if your pet needs time or support to learn? *

How do you usually approach challenges like training or behavior concerns such as chewing, scratching, barking, or other destructive behaviors? *

What questions do you have about training your new pet?

Animals may take a month or longer to adjust to their new home. How do you plan to help your pet adjust to a new home? *

- -

I hereby grant the Humane Society of Barron County permission to confirm any information provided in this application for the purposes of determining adoption eligibility. I understand that my application may be denied if I provided any false information. I understand completion of this form does not guarantee approval to adopt. I understand the Humane Society of Barron County reserves the right to deny any applicant for any reason. *

- -

Please note: When we receive a high volume of applications the HSBC is not always able to respond to every application. Please be patient as we work to find loving homes for the animals in our care.

By signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application. *Click on the line, hold down the mouse, and draw your signature. *

Date: *

I understand and acknowledge that, as part of the adoption process, an in-person appointment is required to allow interaction with the animal for which I have applied. I recognize that animals may behave unpredictably and that any interaction with animals, or any interaction with or at the Humane Society of Barron County, carries inherent risks, including but not limited to scratches, bites, falls, allergic reactions, or other injuries or property damage.

By participating in the appointment and any interaction with the animal(s) or at the Humane Society of Barron County, I voluntarily assume all risks associated with such participation and interactions. I hereby release, waive, and hold harmless the Humane Society of Barron County, its officers, directors, employees, volunteers, agents, and representatives from any and all claims, liabilities, damages, injuries, losses, costs, or expenses arising out of or related to my participation in the appointment, my presence at the Humane Society of Barron County, or any interaction with any animal.

I further acknowledge that I am responsible for supervising any minor children accompanying me during the appointment and assume all responsibility for their conduct and safety.

Signature of Primary Adopter *

Date *

Signature of Secondary Adopter (must have signatures from all adults attending in-person meetings). *

Date *