Adoption Form | Stillwater Humane Society

Name *

First

Last

Phone

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

What type of dog/cat are you looking for? (size, age, sex, etc.) *

What type of accommodation do you live in? *

Who owns your accommodation? *

If renting, please provide Landlord's contact information:

Name:

Breed:

Age:

Sex:

Spayed/Neutered?

Name:

Breed:

Age:

Sex:

Spayed/Neutered?

If Necessary Please List Additional Animals Here:

How many people live in your household and what are their ages? *

On an average day, how long would dog/cat be left on it's own and why? *

Where will you keep your pet during daytime and nighttime? *

Do you have a fenced yard? *

If yes, please describe the type and height:

To feed, vaccinate, license, and provide medical care for this pet, how much do you anticipate to spend yearly? *

What behaviors, if any, can you just not tolerate, or do you feel would be difficult for you to manage? *

Would you like more info on crate training for your new dog? *

Name and telephone of veterinarian you are currently using or plan to use: *

Would you be willing to allow a Human Society representative to conduct a home visit? *

Please list a reference that is familiar with your relationship with animals: *

How did you hear about the Humane Society of Stillwater: *

Please Sign: *

Date: *