The Animal Shelter - Adoption Application
1201 Parkwood Drive
Anniston, Alabama 36201
First Name Last Name Telephone Number
Street City State Zip Code
Date of Birth Place of Employment
Work Telephone Email Address
Have you adopted from the Animal Shelter before? Yes No
You are adopting a companion animal for Yourself Children Friend Gift Other Explain: Do you live in a: House Apartment Mobile home Condominium Other Explain:
Do you own your own home? Yes No
If renting, does your landlord allow pets? Yes No
Landlord’s Name Telephone Number
Do you have a fenced in yard? Yes No
Where do you plan on keeping this pet?
List any additional people your new pet will be living with (specify age of any minors):
Name Age Relationship
Name Age Relationship
Name Age Relationship
Name Age Relationship
Name Age Relationship
What will happen to your pet if you move unexpectedly?
How many animals have you owned in the last 3 years? Include those you currently own:
Dog(s) Cat(s) Other
Breed Owned for Age Spayed/Neutered Yes No
Breed Owned for Age Spayed/Neutered Yes No
Breed Owned for Age Spayed/Neutered Yes No
Breed Owned for Age Spayed/Neutered Yes No
If you no longer have some or all of these animals what happened to them?
Why are you adopting this companion animal?
Have you given thought to pet ownership responsibilities?
Veterinarian Name Telephone Number
By applying for the adoption of this animal, I hereby give permission to my veterinarian and my landlord, if applicable, to disclose information to the Animal Shelter. Yes No
CONDITIONS OF ADOPTION:
In choosing to adopt this animal I agree to the following conditions established by THE ANIMAL SHELTER:
To provide food, shelter and humane treatment of this animal at all times Yes No
To provide annual immunizations as required by state law Yes No
To prevent this animal from running at large (dogs must be on leash or kept in enclosed area ) Yes No
To prevent this animal from being used for experimentation Yes No
To submit to an investigation should it be determined that conditions of this adoption are not being complied with. Yes No
I understand that all sums are considered donations and, as such, are nonrefundable. Yes No
As the owner of this animal, I release THE ANIMAL SHELTER and/or any participating veterinary hospital of any and all damages resulting from spaying or neutering, and will accept sole responsibility for any additional costs. Yes No
I accept full responsibility for this animal’s personality and temperament. Yes No
I understand that THE ANIMAL SHELTER reserves the right to reclaim said animal if conditions are not complied with. Yes No
I have read and understand the conditions of this adoption and agree to them. Yes No
I certify that all information contained herein is true and acknowledge that giving false formation will void the adoption. Yes No
Full Name Date
