Adoption Application HSCCL

Applicant's First Name *

Applicant's Last Name *

Home Phone

Cell Phone *

Email Address *

What is the best way to contact you?

Street Address *

Apartment Number (if applicable)

City *

State *

Zip Code *

Are you over 18 years of age?

Drivers License Number *

If you have a specific animal you are interested in adopting, please select them from the list

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?

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?

What age range(s) are you considering

What activity level are you considering? Check all that apply

Do you own other animals? *

If you own other animals, are you willing to bring them to a meet and greet before adopting?

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. *

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

Will this pet be predominantly living inside, outside, or both?

Do you have a completely fenced-in yard? If so, what kind of fence?

If you answered "no fence" or "other" above, please explain:

Have you ever turned your dog or cat into a shelter?

If yes, please explain?

Have you ever had a pet euthanized?

If yes, please explain:

Have you ever been convicted of abuse or neglect of a child or animal?

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. *