Adoption Form

Pet Interest

Name of animal you're interested in adopting:

Today's date mm/dd/yyyy:


Personal Information

Are you over the age of 18?:
yes no 

Your full name:

Your Email

Street Address

City:

State:   Zip:

Day/Work/Phone:

Home/Evening/Cell:

Place of employment (you):   Occupation (you):

Place of employment (spouse):   Occupation (spouse):


Vet and Personal References:

Provide the contact information of a veterinarian you have used before and/or plan to use with your new dog/cat? Vet and Personal references will be checked by shelter manager.

1 Vet name/phone:

2 Vet name/phone:

Personal Reference 1 Name/Phone:

Personal Reference 2 Name/Phone:


Household Information:

What type of residence do you have:

Do you own or rent:

If you rent, you must provide the name and phone number of your landlord so that we may confirm that you are permitted to have pets:
Landlord Name:   Landlord Phone:

List the names, ages, and relation of all persons who currently
live at this residence:

Do any residents of this house of
known allergies to cats or dogs:
 yes no

If yes, please explain:


Pet History

List information for any pets currently residing in household,
including breed, sex, age, neutered/spayed, how long owned, kept
where:

Have you owned any other pets:
 yes no

If yes, provide the following information for each pet:
name of pet, where is the animal now, year of death (if decesased),cause of death (if deceased):

Have any of your pets ever had puppies or kittens:
 yes no


Care of the Animal

Do you have a fenced in yard? if so, please describe
type of fence & yard:

If you do not have a fence, please tell us how you plan to
let the animal relieve itself:

Do all of the adults work full time:
 yes no

How many hours per day will your pet be home alone:

Where will your new pet sleep:

Where will your new pet spend the majority of it's time:

What sort of training to you plan to provide for your new pet:

Where will your new pet be kept when it is alone:

Have you ever taken one of your pets to a shelter? Have you ever taken one of your pets to a shelter? (if so, please describe the circumstances):

Please describe your home & yard (ex. single family home on well traveled street with a small front yard):


Additional Info

We request an adoption fee donation. The cost varies depending on several factors. The money supports the operation of our shelter, including daily care, vet care and rescue. Is this acceptable?:
 yes no

Please realize that dogs can live to 15 years of age, cats up to 20 years of age, and other animals vary. Your pet will need vet care throughout it's live, including yearly boosters, heartworm and flea/tick preventive meds, etc. Are you financially able to provide professional veterinary care for the foreseeable lifetime of the animal?:
 yes no

Please list any additional comments you would like to add:

Please sign me up for Animail so I can receive the shelter newsletter, news and event updates via email:

*By clicking the Submit button below I agree to the terms and conditions of the shelter. I have read the Adoption Tips. I certify the above information is accurate and complete to the best of my knowledge. I authorize the release of veterinarian information related to my past and current pets. I give the SC-SPCA permission to contact the persons listed above for a character reference. Any incomplete or inaccurate info will be grounds for application denial.