| © Morristown Hamblen Humane Society Adoption Application
Name _________________________________________________________________________________ Phone (H) ______________________________________(C) ____________________________________ Address_______________________________________________________State _____ Zip ___________ Do you own ___________ or rent ___________ you’re home? If renting is pets allowed ______________ Landlords Name/Phone# (required) _________________________________________________________ Renting Restrictions _____________________________________________________________________ Your Occupation ____________________ How many hours are you away from home each day? ________ Do all family members work outside the home? _______________________________________________ Have you owned a pet before? ______ Kinds? ________________________________________________ What happened to him/her? _______________________________________________________________ Do you currently have other animals? _________________ (if yes please list) Type Name Age Sex Spayed/Neutered _______________ _____________ __________ _________ ___________________ _______________ _____________ __________ _________ ___________________ _______________ _____________ __________ _________ ___________________
Do you’re pets have any characteristics that we should be aware of? _______________________________ Who is your veterinarian? Name________________________________ Phone#_____________________ Are you aware of the veterinary care and finances this animal will need in the future are willing to take care of all of his/her needs requirements (shots, flee preventative, etc.) Yes _______ No ________ Where will you’re pet be during the day? _____________________ At night? _______________________ Where will you’re pet be when you are out of town? ____________________________________________ How do you plan to confine the pet to you’re property? _________________________________________ Are you currently expecting a child/planning for a child? Yes No Does anyone in your house have allergies Yes No Ages of people in your house _____________ Are you aware of local ordinances (regarding control laws, rabies vac. Shelter, food, water) Yes No Why are you interested in this specific animal? ________________________________________________ ______________________________________________________________________________________
I acknowledge that all the information on this form is true and correct.
Signature (Applicant) __________________________________________Date ______________________ |