Adoption Application First Name Last Name Address Line 1 Address Line 2 City State/Province/Region Zip Code Email Phone Number Type of residence? House Apartment Condo Duplex Mobile Check all that apply. Private backyard Fenced yard Common area Other Landlord contact info if renting? Previous Address? How many hours a day will your pet be left alone? Enter name and age of everyone in your household. What is your veterinarian’s name and phone number? I want to adopt? Cat Dog List current pets. List previous pets. List references. Do you agree with the following statement? I agree Consent Form Before adopting a pet from HSMC, you must agree to the following, Animals are adopted from HSMC: Are adopted as household pets and companions. Cannot be adopted as gifts. Shall not be given away or sold to other individuals or commercial laboratories. Must be returned to the shelter if the adopter can no longer keep or maintain the animal properly. All male and female animals must be spayed/neutered. A veterinarian must examine all animals within 15 days after they are adopted. An adopter must be 18 years of age or older. An adopter must have identification showing their present address. An adopter must have the knowledge and consent of their landlord. An adopter must be able and willing to spend the time and money necessary to provide training, medical treatment, and proper care for the pet. Each potential adopter must fill out an adoption questionnaire providing such information as name, address, information existing pets in the household, landlords’ name and telephone number (if applicable), personal references, veterinarian reference, authorization for release of information by the Veterinarian, and the reason for wanting the pet. HSMC shall review each application and obtain feedback from references and veterinarians. Within 48 hours, the review shall be completed and approved or disapproved. However, if the potential adopter does not fully complete the questionnaire, the time frame for completion cannot be accomplished until the potential adopter provides the required information. At the time of adoption, the adoption fee is required, cats are $85 dogs are $150 The adopter is required to sign an adoption contact acknowledging receipt of the pet and agreeing to care for the pet humanely and in accordance with all State and County laws pertaining to animals, including prohibiting an animal from running at large, dog licensing and rabies vaccinations for dogs and cats, and to comply with the deadline required for spay/neuter. The terms of the contact also state that the potential adopter agrees that HSMC may examine and make inquiry about said animal at any time and if not satisfied with conditions, may require surrender of said animal. HSMC will not be responsible for any accidents, injuries or illness of any animal adopted from the shelter. The Humane Society of Morgan County reserves the right to investigate new homes and remove the animal if it is not receiving adequate care, has been mistreated, or the spay/neuter requirements have not been met. Prior to adoption, all cats are combo tested for FIV, leukemia; are up to date on their vaccines, including rabies and are de-wormed and de-fleaed. Our dogs are up to date on their vaccines, including rabies, de-fleaed and de-wormed- all animals are spayed or neutered if over 6 months. If under 6 months, we provide a $30 certificate towards the spay/neuter.