Dog Adoption Form | McCook Humane Society

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McCook Humane Society's
Dog Adoption Form

To apply to adopt a dog, complete and submit the handy form below, or download the PDF here, print, and mail or drop off at the shelter.

Dog Adoption Form

Name *

Name

First

Last

Email *

Name of Dog *

Are you over 21 years of age? *

Yes

Address *

Address

City

State/Province

Zip/Postal

Country

How long at this address? *

Daytime Phone *

Evening Phone *

Own your home? Or do you rent? *

Own

Rent (must have landlord approval)

Is your yard fenced? *

Yes

How will your dog be exercised? *

How often? *

Where will he/she spend the day? *

Where will he/she spend the night? *

If outside, do you have shelter available for him/her?

Yes

Have you owned pets in the past 3 years? *

Yes

If yes, what happened to them?

What animals do you own now? *

Are they spayed or neutered? *

Yes

I don't have any pets

If no, please explain:

If you own other dogs or cats, are they current on vaccinations? *

Yes

What is the name & phone # of your veterinarian?

Are there children in the family? *

Yes

If yes, what are their ages?

Are there other adults in your household? *

Yes

If yes, please list names of all other adults in household:

Are you financially prepared to provide the necessary care for your pet: including proper food, vaccinations, parasite control (fleas, ticks, worms, etc.), adequate shelter, and veterinary care for yearly check-ups and medical emergencies? *

Yes

Have you ever placed a pet in an animal shelter? *

Yes

If yes, what was the reason?

By typing my full name below, I affirm that all information above is true. I realize that this is a lifetime commitment and will endeavor to give this pet a happy and healthy home. If for any reason I can no longer keep this pet, I will first contact the McCook Humane Society. *

TYPE FULL NAME HERE

Captcha

If you are human, leave this field blank.