Name:

Address:

City: State: Zip Code:

Home Phone Number (Including Area Code)

Work Phone Number (Including Area Code)

Email Address:

What breeds of dogs are you most interested in adopting?

Why?

Would you like to be put on a waiting list?

As with any rescue animal, AAR animals may not be housebroken, may have been abused in the past, or may have treatable medical problems. In some cases, these problems may not be realized until after the dog has been placed in it's new home. If you are approved for adoption, are you willing to work with your new pet to give it the new life it deserves?

Why do you want to adopt?

Do you understand and accept that changing an animal's environment may cause the animal to have accidents, especially in the early days of the adoption?

If a behavioral problem arises, what steps will you take to work with this animal?

Do you live in a House:Apartment:Other:

Do you have a fenced yard? Yes No

If yes, how high is the fence?

Do you: Own Rent your home.

If you rent, are pets allowed? Yes No No Sure

If you rent, what is the name of your landlord?

What is the phone number of your landlord?

Are you adopting for: Yourself Gift

Have you ever owned a pet before: Yes No

Do you own a pet now? Yes No

How many dogs and/or cats do you own: Dogs Cats

How long have you had them?

If you do not own a pet now, have you owned a pet in the past 3 years? Yes No

If yes, where are the pets now?

Have your pets been spayed or neutered? Yes No

If not, why?

Who is your Veterinarian:

What is your Veterinarian's phone number?

Will your pet be kept? Inside Outside Both

Where will the animal sleep? Inside Outside

What will you do with your animal if you move or change housing?


Have you adopted a pet from a shelter before? Yes No


I have read the above information carefully and have filled out this application honestly. I understand that there is no guarantee made or implied that any person requesting to adopt an animal will be allowed to adopt. All decisions on adoptions are subjected to the approval of the Humane Society of Shelby County or the foster that has been caring for the animal. I understand that if I do adopt, I agree to the terms and conditions established by the Humane Society of Shelby County. I agree that any animal that I adopt will be spayed or neutered. I agree to allow the Humane Society of Shelby County to contact my current or previous veterinarian as deemed necessary in order to check my current or past records. I agree to provide annual immunization as required by the State of Alabama.

By pressing the "Submit" button you attest that you have read the above disclaimer and agree to the terms of this agreement.