Adoption Application HSCCL
Applicant's First Name
*
Applicant's Last Name
*
Home Phone
Please use the following format 248-555-1212
Cell Phone
*
Email Address
*
Please enter carefully as this is the main way we will contact you
What is the best way to contact you?
Cell Phone
Home Phone
Email
Street Address
*
Apartment Number (if applicable)
City
*
State
*
Zip Code
*
Are you over 18 years of age?
No
Yes
Drivers License Number
*
If you have a specific animal you are interested in adopting, please select them from the list
Amos (Dog - 24-618)
Athena (Dog - 24-722)
Atlas (Dog - 24-719)
Babe (Dog - 24-822)
Bindi (Dog - 24-730)
Bonnie (Dog - 24-773)
Brooks (Dog - 24-824)
Bruno (Dog - 24-789)
Clarita (Dog - 24-755)
Dixie (Dog - 23-716)
Donnie (Dog - 24-775)
Duke (Dog - 24-422)
Eli (Dog - 24-771)
Emerald (Cat - 24-820)
Esther (Dog - 24-617)
Gemma (Dog - 24-353)
Gigi (Dog - 24-807)
Hazel (Dog - 24-726)
Heidi aka Sadie (Dog - 23-749)
Iris (Cat - 24-794)
Ivory (Dog - 24-836)
Izzie (Dog - 24-837)
Lana (Dog - 24-558)
Lola (Dog - 24-372)
Magnolia (Cat - 24-798)
Mary (Dog - 24-395)
Nigel (Dog - 24-754)
Oatmeal (Cat - 24-787)
Ollie (Dog - 24-772)
Penelope (aka Pistol) (Dog - 24-231)
Princess (Dog - 24-542)
Reese (Dog - 24-811)
River (Dog - 24-812)
Salem (aka Sadie) (Dog - 23-746)
Sasha (Dog - 24-014)
Thing 2 (AKA Precious) (Cat - 24-785)
Thomas (Dog - 24-572)
Thorn (Cat - 24-795)
Tony (Dog - 24-791)
Toren (Dog - 24-573)
Tulip (Cat - 24-793)
Violet (Cat - 24-797)
Zoey (Dog - 24-706)
List any other pets you're interested in meeting
If you haven't selected a pet from our Adoptable Pets page, what type of pet are you looking for?
Large Dog
Medium Dog
Small Dog
Puppy
Adult Cat
Kitten
If you have a breed in mind please list. Keep in mind most of our pets will be a mix of breeds
Are you looking for a male or female?
Male
Female
No Preference
What age range(s) are you considering
Senior
Adult
Youth
Puppy
Kitten
What activity level are you considering? Check all that apply
Running Buddy
Couch Potato
No Preference
Do you own other animals?
*
No
Yes
If you own other animals, are you willing to bring them to a meet and greet before adopting?
No
Yes
We do adoptions by appointment only. We are closed on Sundays and Mondays. Please choose a day that you would be available for an appointment.
*
Tuesday
Wednesday
Thursday
Friday
Saturday
If you rent, does your landlord and lease allow pets?
Yes
No
Unsure
N/A
Will this pet be predominantly living inside, outside, or both?
Inside
Outside
Both
Do you have a completely fenced-in yard? If so, what kind of fence?
Wood
Chain Link
Electric
Plastic
Iron
Other
Other (I do not have a fenced yard)
If you answered "no fence" or "other" above, please explain:
Have you ever turned your dog or cat into a shelter?
No
Yes
If yes, please explain?
Have you ever had a pet euthanized?
No
Yes
If yes, please explain:
Have you ever been convicted of abuse or neglect of a child or animal?
No
Yes
If yes, please explain:
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal.
*
Yes
No