Melinda - Adopt App - Humane Society Of Wilkes

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Humane Society of Wilkes Foster Adoption Application

You can apply to adopt a foster animal Online by filling out this form.
Adoption Fee for Dogs - $120
Adoption Fee for Cats - $80

Foster Adoption Application

* Indicates required field

Application for (name of pet) *

Your Name *

First

Last

Preferred Phone Number *

Email Address *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Who will be responsible for the care of this pet? *

Self Other

If other, please specify name, age and relationship of this person to you: *

If adopted, will this pet live with you? *

Yes No

If no, please explain: *

Do you live in a... *

If other, please explain: *

Do you rent or own your home? *

Rent Own

If renting, do you have landlord’s permission to keep a pet? *

Yes No

Landlord's Name *

First

Last

Landlord's Phone *

Please describe where and how this pet would be kept most of the time: *

Is any part of your yard fenced in? Please describe: *

How long would the pet typically be alone on most days? *

How many adults are in the household? *

How many children are in the household, and what are their ages? *

Do all household members want to adopt this pet? *

Yes No

If adopting a cat, do you plan on declawing? *

Yes No Not applicable

Please describe current and past pets with each of the following details for each pet (1. Pet Name, 2. Kind of Animal, 3. Breed, 4. Age, 5. Sex, 6. whether current on vaccinations, 7. whether spayed or neutered, 8. what happened to them if past pet): *

Example: Rex, Dog, Boxer Mix, about 7 y/o, male, current, neutered, gave to my son

Are you willing to let a HSOW member (or designee) visit your home? *

Yes No

Name of your most recent veterinarian: *

First

Last

Phone Number of your most recent veterinarian: *

Please feel free to write anything else that you would like us to know about you as a pet owner and/or about your plans for caring for this pet.Comment *

Electronic Signature *

I certify that the above facts are true to the best of my knowledge.

Submit

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336-838-9588

Humane Society of Wilkes
P.O. Box 306
North Wilkesboro, NC 28659