Adoption Application

First Name

Middle Name

Last Name

Phone Number:

What is your email address?

Address

City

State

Zip Code

Employer

Are you 18 years of age or older?

Click for YESClick For No

How long have you lived at your current address?

Do you rent or own your residence?
RentOwn

If you rent, who is your landlord?

If you rent, what is your landlord's phone number?

If you rent, will you be able to show written permission to keep this animal?

Click for YESClick For No

What is your dwelling type?
HouseApartmentMobile HomeCondo

How many people are in your household?

Are any of the people in the household children?
Yes No

If there are children in the household, what are there ages?

If adopting a cat, do you plan to have it de-clawed?
YESNoI'm not adopting a catMaybe

Where will this pet live?
Indoors OnlyOutdoors OnlyBoth inside and outside

If the pet will be an outside pet, what kind of shelter will be provided?

What will happen to your pet if you move?

What will happen to your pet if you go on vacation or have an emergency?

How many pets do you currently have?

Have you adopted from us before?
Click for YESClick For NoI've adopted from other shelters before

What is the name and phone number of the veterinarian you will use?

May we call the veterinarian for a reference?
Click for YESClick For NoOkay, but there's no point because I haven't had a pet before

Are you aware of medical treatment necessary for a pet? (heartworm prevention, flea & tick treatment, annual checkups, and shots) How much do you think the annual cost of pet care will be?
$50.00$150.00$300.00More than $300

By submitting this application, I declare that all information provided is true. Blount County Animal Shelter, Inc. reserves the right to follow up on every pet adopted, and has the right to refuse any adoption. This document is the property of Blount County Animal Shelter, Inc. and will not be returned to me.

IP Address

Date

or Reset

Optimus Template

Your Site Slogan

Donate a bed

Adoptable Animals

Check out our adoptable animals.

Adoption

Adoption Application

Stay Tuned

Stories of Hope

B~SNAP

Become a BCASI Member