Adoption Application

Owning a pet is a lifetime commitment. Our adoption program is designed to ensure the placement of our animals into permanent, responsible, loving homes. Applicants of outside only dogs must be willing to spend sufficient and quality companionship time with the dog. Approval of any application is at the discretion of the Animal Shelter staff, and will be made in the interests of finding the best permanent home for our animals.

. You must be 18 years old to adopt a pet. We discourage college students from attempting to adopt unless they are at the graduate level.

. Pets under 4 months of age might not be adopted to families with children under 5 years of age.

. Written landlord consent is required prior to adoption.

. Adopted pets may not be given as gifts to other people.

. No animal will be adopted to persons that have a confirmed history of neglect or abuse of animals or to persons that have surrendered a personal pet to the shelter.

. No animal will be adopted to persons that have a repeat history of losing, giving away, selling, or having animals injured or killed.

. Only dogs that are physically and temperamentally suited to living outdoors will be adopted as outside dogs (i.e., no daily access to inside of owner’s home). According to local ordinances and laws, all dogs must be kept under control and not be allowed to run at large. Therefore, dogs that are adopted as outside pets must have a fenced or an adequately sized enclosed area to live in and a doghouse or other suitable shelter. Because of the need for socialization, puppies under 6 months of age will not be adopted as outside dogs. Applicants wanting to adopt an outside dog may be required to undergo a home visit prior to the approval of an adoption application.

. If at any time, you are no longer able to keep the pet you have adopted, you must return it to the shelter.

. We do not adopt animals to persons that plan on chaining animals as a means of containment.

. Be aware that we check all references.

. ALL ANIMALS ADOPTED FROM THE SHELTER MUST BE SPAYED OR NEUTERED PRIOR TO LEAVING THE SHELTER.

Ripley County Humane Society

Adoption Application

Adopting a pet is a big responsibility and should be considered very seriously. Each animal has unique characteristics and special needs. In order to help us place our animals in a suitable household, please take a few minutes and complete this questionnaire as accurately as possible.

Name of Applicant Date

Phone E-Mail

Address City/ST/Zip

Name of the animal you wish to adopt?

Number of people in household: Adults Children Ages

Why do you want to adopt a pet?

What type are you looking for?

How did you hear about us?

Have you ever owned a pet? YESor NO If so, when and for how long?

What pets do you currently have at home? Spayed/Neutered? YESor NO

Do you live in town or in a rural setting?

House, apartment, condo? If renting, are pets allowed? YESor NO

Will this be an inside or outside pet? INor OUT

If outside, is a fenced yard available? YESor NO

Who will be mainly responsible for animal’s daily care? Age?

On a typical work day, how long will this animal be alone?

Where will pet be when no one is home?

If you move, would you take the animal with you?

Are you aware that you could be making a 15 year commitment or longer? YESor NO

Who is your current veterinarian or clinic?

May we call them? YESor NO Phone Number

Will you provide annual medical treatment and check-ups for your pet? YESor NO

Do you know additional vaccinations are necessary besides what is covered by the adoption fee?

YES or NO

Do you agree to let us visit you at home after the adoption takes place? YESor NO

Directions to your home from the shelter

List two non-related references

Name Phone

For an adoption fee of $__________ the Ripley County Humane Society provides the following: spay or neuter, rabies vaccine (for adult dogs), first distemper vaccine, fecal test, first worming, heartworm test (if applicable), feline leukemia test (if applicable).

PLEASE READ THE FOLLOWING CAREFULLY

Applicant agrees that if adoption is approved, Ripley County Humane Society, Inc. (RCHS) may make unannounced visits to applicant’s home to check on adopted animal. Applicant agrees that if RCHS is not satisfied with treatment of adopted animal, applicant will relinquish possession of animal back to the humane society upon demand.

Applicant agrees to hold RCHS blameless for any injury to themselves or to any other person, or destruction of property caused by adopted animal while in their possession.

Applicant agrees to treat adopted animal in a kind and loving manner and to provide the adopted animal with adequate and safe surroundings, shelter, food, and water.

Ripley County Humane Society Applicant

By Date

□ Approved □ Not Approved Animal Name ____________________________________

Payment Type ________________________________ Amount $________________________

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