Online Adoption Application Form | Anderson Humane Society, Inc., Lawrenceburg, KY

Pet Information

Please list any and all particulars of pets you currently own or have owned in the past.

Introduction

Pet Name *

Dog or Cat? *

Dog

Cat

Male or Female? *

Male

Female

Spayed or Neutered? *

Yes

Breed *

Current Age *

History

Age of pet when acquired *

Age of pet when last owned *

What happened, if no longer owned?

Health

Date of last vaccinations *

Health Status *

Veterinary's Name *

Veterinary's Phone Number *

Veterinary's Address *

Veterinary's Address

City

State

Zip Code

List any current problems with the pet *

Add Additional Pet Remove Additional Pet

Adoption Terms & Consent

Would you object to an Authorized Representative of the Anderson Humane Society Adoption Center visiting your home prior to adoption? *

Yes

Would you object to a follow up visit or for them to verify any of the above information? *

Yes

Is there anything you would like to tell us regarding why you feel you could provide a good home for this animal? Why should we choose you over other applicants that may be wanting to adopt this particular animal? *

Should you be unable to keep this animal after adoption, you MUST return it to the animal shelter. Do you agree that you will surrender the animal back to us should you not be able to keep it? *

Yes

Thank you for filling out this adoption application. It is not our intent to invade your privacy; our sole purpose is to find a caring, responsible and permanent household for our animals and at the same time find a suitable pet for you to love and enjoy for many years!

By signing this form, you give consent that all information pertaining to this form is accurate to the best of your knowledge. Your online signature will be representative of a print signature.

I have read and agree to the terms of the Anderson Humane Society Adoption Application. *

I agree

e-Signature *

Date *

If you are human, leave this field blank.

Making Friends

Anderson Humane Society

Online Adoption Application

Your Information

Pet Information

Adoption Terms & Consent

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