Salado Humane Society

ADOPTION APPLICATION

Animal ID #:________________ Tag #: _______________ Vaccinated On: _______________

Veterinarian:____________________________________________________________________________________

* This section to be filled out by SHS representatives

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APPLICANT INFORMATION:

Thank you for considering a companion from the Salado Humane Society. Adoption policies of the SHS help to ensure that each adoption is in the best interest of both the animal and the adopter.

In order to qualify as an adoptor, you must:

Be at least 18 years of age
provide verification of current address
Have knowledge and consent of all adults living at this residence
Renters must have consent of landlord
Ensure that animals you currently own are current on all vaccinations
Understand that, by submitting this application you are giving permission to the SHS to verify your information
Understand that the SHS reserves the right to approve or deny any application.
Understand that a representative from SHS may come to your home for a pre adoption visit
Understand that a representative from SHS may come to your home for a follow up visit to ensure the well being of any adopted animals

Please provide the following information:

Name:__________________________________________________ Home Ph.____________________________

Cell Ph.______________________________ email address:____________________________________________

Address:_____________________________________________________ City:___________________________

State:____________________________ Zip code: __________________________

Residence is: ______ House ______ Apartment ______Condo ______ Mobile Home

If renting, Name & phone number of landlord: _________________________________________________________

Are all adults living at this residence in agreement with this adoption? ________________________________________

Do you have a fenced yard? ___________ If no, please indicate how you will keep this animal confined to your property: ____________________________________________________________________________________

If kept outside, what type of shelter do you have?______________________________________________________

____________________________________________________________________________________________

Are all pets living with you current on vaccinations?_____________ If no, please indicate why:____________________

____________________________________________________________________________________________

Please list pets you currently have or have had in the last 5 years, their ages and health status:______________________

____________________________________________________________________________________________

Please read and initial beside each of the following:

_____ I understand that animals adopted from the SHS are "random source" animals that have been accepted from anyone and anywhere.

_____ I understand that SHS does it's best to screen the health and disposition of each animal; however, animals can appear healthy and not display signs of disease for weeks or months. The SHS cannot guarantee the health of any animal adopted.

_____ I understand that many diseases are airborne and can be transmitted to other animals that are not fully vaccinated and the SHS can not be liable for the health and safety of unvaccinated animals I currently own.

_____ I understand that if a adopted animal develops a health problem, it is my responsibility to secure medical treatment at my own expense.

_____ I understand that animals adopted from the SHS receive their initial vaccinations and when necessary, I am responsible for boosters, yearly check-ups, etc.

_____ I understand that all animals not spayed or neutered at the time of adoption must be spayed or neutered within 30 days of adoption. If I fail to do this, SHS has the right to revoke the adoption and take possession of the adopted animal. *Upon approval of SHS special arrangements may be made to extend the spay/neuter date.

_____ I understand that adoption fees range from $45.00 to $100.00 and are assessed in accordance with each individual animals medical history and needs.

_____ I understand that SHS does not give cash refunds, but if the adoption does not work out due to no fault of my own special considerations may be made. Upon approval of SHS I may be eligible to choose another animal for exchange.

_____ I understand that State law requires all dogs and cats to be vaccinated for rabies by age 4 months.

_____ I understand that SHS cannot guarantee the health of the animal being adopted and accepts no responsibility if animals I currently own are not protected by all vaccinations recommended by the American Veterinary Association.

Upon approval of my application, I agree:

To provide the necessary vaccinations to maintain a healthy animal.
To provide adequate food, water, shelter & humane treatment.
To obey all state and local laws pertaining to animal health & welfare.

I have read and understand the policies and requirements pertaining to the adoption of an animal from the Salado Humane Society. By submitting this application, I agree to abide by the terms of this agreement.

Signature of applicant:_________________________________________ Date:_________________________

Signature of SHS Representative:_________________________________ Date:_________________________