EmailMe Form - Hardin County Adoption Application

Hardin County Adoption Application
Instructions: Please enter your information. Answer all questions.

Dog I am applying for: *

Name

Prefix

First

Last

Suffix

Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Phone Number

###

####

Email

Date of Birth *

Do you own your home? *

Yes

Do you rent your home? *

Yes

If yes, your Landlord's name and phone number is required, please list that information below:

Does your lease allow pets? *

Yes

What is the reason for adopting this animal? *

Child/Family Pet

Hunting

Breeding

Guard Dog

Barn Cat

Gift

Will this animal be in contact with samll children for extended periods? *

Yes

Do you currently have any other pets? *

Yes

Current Pets

Please list current pets below:

Name of pet/breed/and how long you have owned each pet? *

Any additional information about your current pets you want us to know: *

Are they fixed? *

Yes

Vaccinations and county license up-to-date? *

Yes

If you have owned pets within the pst five years but no longer have them, what happened to them? *

We require the name, number and address of your veterinarian *

Address: *

Phone Number *

###

####

Whos name are the records in? *

Where will the adopted pet be kept? *

Indoors

Outdoors

Kennel

Chained

Have you ever turned in a or surrendered and animal to this shelter? *

Yes

Have you adopted an animal from this shelter before? *

Yes

If yes, what breed and when? *

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not adopting a pet from Hardin Co. Animal Control.I have read a copy of the Hardin County Animal Control Adoption Agreement, I understand and comply with all terms of the process. The application process may take up to 10 days, if your applicatioan is selected we will contact you by phone or email.

Do you agree with the terms and conditions? *

Yes, I agree.

Initial *

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