Adoption Application - Lower Mainland Humane Society

Date of Application:

Applying to adopt (breed):

Name of pet, if indicated:

Name of Applicant:*

First Last

Are you 21 years of age or older? (Proof may be requested.)*

Yes
No

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Place of Employment:

Are you applying for a cat or dog?

Cat
Dog

Why are you considering adopting a pet?

What do you feel are the most important responsibilities of owning a pet?

Please list any preferences (age, sex, breed, temperament, activity level, etc.)

Have you ever had an application for adoption declined by an animal group/animal control or rescue facility?

Yes
No

If yes, please explain:

What type of residence do you live in?

If Other, please specify:

Do you…

Own
Rent
Sublet

Where would the animal be primarily housed?

Inside
Outside
Equally Inside and Outside
Indoor Only (Cat)
Indoor/Outdoor (Cat)
Outdoor Only (Cat)

Where would the animal stay when you are not home?

Loose inside
Crated/confined inside
Loose outside
Kennel run/fenced area outside
Tied/chained outside

Do you have a yard?

Yes
No

If yes, is it fenced?

Yes
No

If fenced, what type of fence (materials used):

Height of fence and approximate size of fenced in area:

Does the fence belong to you or the neighbors?

Are there holes or gaps in the fence?

Yes
No

If yes, will you be fixing them?

Yes
No

Number of gates:

Are the gates always securely latched/locked?

Yes
No

If the animal is outside other than for supervised activities, describe what shelter would be available for it:

Shed
Covered area (i.e. porch)
Doghouse
Shade trees
Other

If Other, please explain:

How many people live in the home?

Are there any children in the household?

Yes
No

If yes, please provide age and sex of each child:

Do the children live with your family full time?

Yes
No

Do other children visit?

Yes
No

If yes, how often?

Does your entire household know that you are considering adopting a pet?

Yes
No

If no, why not?

Does anyone in the household suffer from allergies?

Yes
No

If yes, please explain:

For whom are you adopting this pet?

Who will be responsible for feeding and caring for this pet (primary caregiver)?

Who will be responsible for the care of this pet in the absence of the primary caregiver?

What has your family done to prepare for the arrival of this pet?

What will you feed your pet?

Describe the kind of personal situation where you might have to return your adopted pet (i.e. job loss, new baby, moving, marital change, high cost of pet's care, personal illness, etc.):

What problems would make you return a pet?

If Other, please explain:

I am committed to working with the pet to correct any of these and most other problems. To help resolve problems, I am willing to:

Use a crate
Hire a trainer
Take an obedience class
Other

If Other, please explain:

Describe your home's activity level:

Busy/active/noisy
Moderate comings/goings
Quiet, occasional guests

Do you feel that a pet should be spayed/neutered?

Yes
No

If no, why not?

Do you plan to de-claw or debark your pet?

Yes
No

Approximately how many hours each day would the animal be left alone?

How do you reward/praise?

How do you punish?

If your dog chewed up your shoes what would you do?

What kind of games will you play with your pet for stimulation?

Tug of war
Fetch
Wrestling
Hide and seek with toys/treats
Other

If Other, please explain:

Are you willing to take the time to housetrain or litter train your pet and do you understand that changing a pet's environment may cause it to have accidents?

Yes
No

If you came home and your pet had a bathrooming accident while you were out, what would you do?

How often will you exercise the dog and for approximately how long?

Describe the circumstances in which you would walk/exercise a dog off-leash:

If you were to move, what will you do with your pet?

Describe those pets you currently own: (Type of Animal, Breed, Age, Gender, Amount of Time Owned, Vaccinated?)

Please list your current veterinarians:

If any of your pets are not spayed or neutered, please explain why:

What kind of pets have you owned in the past and describe what happened to them:

Animals can be expensive to care for (estimated average annual cost is $1000 for one pet). Have you considered the extra expenses that will come with having a pet, including vet care, food, supplies and equipment, toys, training, boarding and other financial obligations?

Yes
No

Are you willing and able to provide adequate food, shelter and medical care, including yearly checkups and vaccinations, for an adopted animal?

Yes
No

Please provide 2 personal references: (Name, Phone Number, Relationship)

Are you familiar with your local animal control laws?

Yes
No

If at any time during the life of this pet, you are unable to keep it, you must return it to LMHS at your own expense. You may not take it to an SPCA, City Pound, Rescue Shelter, or give or sell it to another individual or group without the permission of LMHS. Do you agree?

Yes
No

Adoption fees are determined by transport costs, medical treatment, and/or other expenses. Do you understand that an adoption fee is between $0-950 for dogs, and $195-650 for cats, unless you are specifically advised otherwise?

Yes
No

Do you understand that you may be asked to provide this animal with needed medication and/or preventative medications?

Yes
No

Individuals who adopt a LMHS dog are contacted periodically for an update to help ensure that the animal successfully adjusts to its new life. If you adopt a LMHS dog, do you consent to home visits before and/or after adoption?

Yes
No

Acknowledgement*

By clicking below, I acknowledge that I have completely read this application, comprehend it fully, and have answered the questions put before me with honesty. I understand that omission of information and/or failure to answer all questions can result in this application being declined. Also, if an omission or untruth is discovered after the adoption takes place, I understand that Lower Mainland Humane Society reserves the right to annul the adoption and reclaim the pet. If the animal is not spayed or neutered at adoption, the adopter is required to alter the animal and provide a veterinary certification of altering to Lower Mainland Humane Society by the date specified in the adoption contract -- animals unaltered by the contractual date may be reclaimed. In addition, each pet adoption is assessed a non-refundable donation, varying by animal to help pay veterinary/other expenses. I give Lower Mainland Humane Society permission to fully investigate the information provided as well as contact veterinarians and related officials. If this application passes this review, I agree to a home and yard visit on a mutually agreed date. I understand that the adoption decision is dependent on many factors including but not limited to the compatibility of the family and home to the individual pet, and other applications received on this pet. I understand that it is Lower Mainland Humane Society’s prerogative to decide which home is appropriate, and therefore I will not argue with the decision.

I agree

What is the best time to call you at home to check on how the adopted animal is adjusting?

Fostering

Lower Mainland Humane Society