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Companion Animal Pre-Adoption Application  
   
 
 
Name of animal(s) you’re interested in
How did you hear about us?
Store Craigslist.org
Website Word of Mouth
Virtual Pet Adoptions Advertising
Pet Finder Video advertising
Other  

Tell us about you!

Name
Address
City   State    Zip
Daytime Phone   Evening Phone
Email
How many people in Home?
Children?
Yes No  
Ages
Where do you live?
Own or rent?
Own Rent 

If you rent, do you have landlord approval to have pets?
Yes No  

**We will need rental permission in writing (if applicable) along with this questionnaire before we can continue with the
adoption process.**
I wish to adopt a
Cat Dog

Do you have other pets?
Yes No  
If so, what kind?
What kind of dog are you looking for?
Size (when grown)
Hair Length
Sex
Age Preference
Any Specific Breed/Type/Mix?
1. Are all adult members of your household in favor of adopting this animal?
Yes No  
2. Is anyone in your household allergic to animals of any kind?
Yes No  
3. Why are you looking for a companion animal? Choose as many as apply.
Security Companion
Company for other pet Gift
Other
4. Will someone be home during the day?
Yes No  
5. What is the maximum amount of time that the animal would be left alone each day?
6. Where will the animal be during the day? Please describe.
7. Where will the animal sleep? Please describe.
8. Do you have a fully fenced yard?
Yes No  

If yes, height of fence?
9. Are you aware that dogs and cats should always wear id tags, and that dogs must be currently licensed and wear that license at all time?
Yes No  
10. Are you aware that, after the initial investment, the average cost of feeding and caring for a pet can be $1,000 per year (or more) for dogs and $500 per year (or more) for cats?
Yes No  
11. Are you prepared to make a commitment to this animal’s lifetime that could last between 10 to 20 years?
Yes No  

I have read and understand the HSMC Statement of Understanding.

I certify that the above information is true and correct to the best of my knowledge. I further agree that any adoption made on the basis of this application is null and void if any of these statements are untrue. I understand that The Humane Society of Mason County's main concern is that all pets be properly cared for by their owners. I understand a minimum donation as required based on fee schedule is necessary to offset the costs incurred related to rescue, care and adoption.

I understand that this application does not constitute a signed adoption agreement.

I understand that The Humane Society of Mason County reserves the right to deny adoption of any animal.

  
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