Humane Society For Hamilton County
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Search
Adoption Application
Step
1
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6
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How did you hear about the shelter or the animal you'd like to adopt?
*
Shelter Website
PetSmart
Petco
Facebook
Twitter
Instagram
TV-News
Radio
A Shelter Email/Newsletter
HSHC Event
Pets Healing Vets
I am interested in adopting a:
*
Cat
Specific Cat
Dog
Specific Dog
Either
Name of the cat or dog you'd like to adopt.
*
TELL US ABOUT YOURSELF
Name
*
First
Last
Address
*
Please note, we are located in Noblesville, Indiana, USA.
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Email
*
Driver's License Number
*
Date of Birth
*
MM slash DD slash YYYY
Cell/Other Phone
*
Home Phone
Work Phone
Emergency Contact
*
Please, list someone other than yourself.
First
Last
Emergency Contact Phone
*
Are you at least 18 years of age?
*
Yes
No
Are you at least 21 years of age?
*
Yes
No
Have you ever surrendered a personal pet to this or any other shelter/rescue group?
*
Yes
No
Please, explain.
Please tell us what type of pet you are looking for:
*
Indoor Pet
Outdoor Pet
Indoor/Outdoor Pet
What would that look like in your household?
*
Is any member of your household allergic to animals?
*
Yes
No
If yes, they are allergic to:
*
Cats
Dogs
Both
Please tell us why you are wanting to adopt a pet
Select all that apply.
Companionship for me/myself
Companionship for my current pet(s)
Protection
Watch Dog
Breeding
Mouser
He/She will be a gift
Please, explain.
*
TELL US ABOUT YOUR HOUSEHOLD
Tell us about your current housing situation
*
Own my own home
Own my own condo
Renting an apartment/condo
Renting a house
Living with parents/relatives
Live in a trailer/mobile home
College Fraternity/Sorority Housing
Landlord's Name:
*
First
Last
Landlord's Phone Number:
*
TELL US ABOUT YOUR FAMILY
Please tell us about your current household
*
Live Alone
Adults Only
Family with children
Are there children/grandchildren who visit your home?
*
Yes
No
Please, list ages of each child that visits and how often they visit.
*
Child
Age
Visit Frequency
Please, list the names and ages of all persons living in your home including yourself.
*
Person
Age
The activity level in your home is
*
Quiet
Active
Very Active
Do all members of your household know you are planning on adopting a pet?
*
Yes
No
How will you confine a pet to your property?
*
Fenced Yard
Garage
Basement
Crate
Loose within residence
Outdoor Kennel
If you have a fenced in yard, what kind is it?
*
Invisible
4 ft Chain Link
6 ft Privacy
Other
Where will this pet be kept during the day?
*
Crate
Restricted to 1 Room in Home
Loose in Home
Outdoor Kennel
Tie-out in Yard
Loose in Fenced Yard
Where will this pet be kept at night?
*
Crate
Restricted to 1 Room in Home
Loose in Home
Outdoor Kennel
Tie-out in Yard
Loose in Fenced Yard
What will you do with this pet when you travel/go out of town?
*
Boarding Facility/Vet's Office
Family or Friends Watch Them
Leave Home Alone
Take With You
What will you do with this pet if you have to move from your current dwelling?
*
Take With You
Re-home to Family or Friends
Return to Shelter
Leave
If adopting a dog, are there any other dogs (other than your own) that this dog must get along with?
*
E.g. relative's dog, neighbor's dog, significant other's dog, etc.
Yes
No
What training methods would you use to handle potential problems with your new pet?
*
Barking and/or meowing, crate training issues, chewing/scratching, housebreaking, going outside the litter box, etc.
TELL US ABOUT YOUR PETS
Do you currently have any pets?
*
Yes
No
How many pets do you currently have total?
*
If yes, please check all that apply:
*
Cats
Dogs
Other
How many years have you owned these pets?
*
What are their ages?
*
Are they male or female?
*
Are they spayed/neutered?
*
Are they kept indoors, outdoors, or both?
*
Are they current on vaccines?
*
Name of your Veterinarian
Veterinarian's Phone
Please tell us about your PAST pets (adult life only - past 10 years).
Previous Pet #1
Cat or Dog?
Cat
Dog
Male or Female?
Male
Female
How long did you own them?
What happened to him or her?
Died of old age
Illness
Ran away
Gave away
Euthanized
Returned to a shelter
Hit by a car
Other
What was their age?
Previous Pet #2
Cat or Dog?
Cat
Dog
Male or Female?
Male
Female
How long did you own them?
What happened to him or her?
Died of old age
Illness
Ran away
Gave away
Euthanized
Returned to a shelter
Hit by a car
Other
What was their age?
Previous Pet #3
Cat or Dog?
Cat
Dog
Male or Female?
Male
Female
How long did you own them?
What happened to him or her?
Died of old age
Illness
Ran away
Gave away
Euthanized
Returned to a shelter
Hit by a car
Other
What was their age?
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