HumaneCNY Adoption Application

Email Address *

How many hours per day will animal be alone *

Is your yard fenced *

Have you ever surrendered or rehomed an animal? *

Applicant's First Name *

Applicant's Last Name *

Personal Reference Name/Number *

Who will care for the animal if something happens to you? *

Street Address *

City *

State *

Apartment number (if applicable)

Zip Code *

Phone Number *

Please select your current residence type. *

Do you own or rent your home? *

How long have you lived at this address? *

Landlord's Name

Landlord's Phone Number

Number of children in home and ages *

Current Employer *

Current Employers Street Address

City

State

Zip Code

Animal you are interested in adopting *

Where did you hear about this animal? *

Will you keep this animal indoors? *

Do you wish to keep the animal as: *

Veterinarian's Name

Veterinarian's Phone Number

Please call your vet and give permission for us to speak with them

Are all of your pets spayed/neutered/fixed? *

Please list all current pets and ages:

If you had pets in the past, what happened to them?

Do you understand this is a 10-18 year commitment *

I give HumaneCNY my permission to contact any parties necessary to verify information I have provided to them in this application *

Our adoption application is designed to help us determine if the adoption is in yours and the animal’s best interest and to place our animals into permanent, responsible homes. We want to assist you in finding the pet most compatible with your lifestyle. Because the animal’s welfare must be our foremost consideration, staff reserves the right to accept or deny any adoption. Staff will review your application to ensure that the animal is going to a good home and that it is also the right animal for you. Have you read and understand the previous statement? *