Statement of Interest

We reserve the right to refuse any adoption. Completion of this application does not guarantee adoption. We may receive more than one application for the same animal. Adoptions are not on a first come, first served basis. You will be notified of your application status within 5-7 days (in most cases sooner) after your application is received.

The minimum adoption donation begins at $120 for dogs and is more for puppies. This includes the first round of vaccines (no rabies vaccine for puppies under four months), spaying/neutering, defleaing, deworming, and micro-chipping.

Age of dog you'd like
Name of animal you'd like
Your First Name
Your Last Name
Mailing Address
City
State
Zip Code
Phone Number
School/Work/Cell Phone
Do you have an answering machine?	Yes  No
When is the best time of day to call you?
Email Address
Would you like to be on the AHS mailing list?	Yes  No
To ensure that this adoption is in the best interest of both you and the animal, we ask that you answer the following questions. This information will help us place our animals in the best possible home, and at the same time find the best possible pet for you.
1. I want this pet for the following reason(s).	Please check all that apply: Dog For my children As my companion For a relative/friend as a gift As a watchdog
2. Do you rent?	Yes  No
Does your lease allow pets?	Yes  No
You must verify approval for a pet by the property owner before we can complete an adoption. We can contact your landlord by phone or you can show us a copy of your lease agreement.
Landlord name
Landlord phone number
3. Do you live in a:	House Apartment Duplex Mobile home park
Are you a student?	Yes  No
If yes, are you:	Full time  Part time
5. If you move, what would you do with this pet?
6. If you are adopting a dog or puppy, is there a yard available?	Yes  No
Is it fenced?	Yes  No
What type of fencing?
How high is the fence?
7. What hours is someone usually home?
8. Where will this pet spend most of its time?
9. Where will this pet sleep?	In the house In the garage In a pet house On the porch Other
10. Do you have other animals?	Yes  No
If yes, how many?
What kinds?
11. How many dogs or cats have you owned in the past five years?	Dogs  Cats
12. Have you had a dog or cat on your property die of a disease such as distemper, feline leukemia, or parvo?	Yes  No
13. Do your other animals have up-to-date vaccinations? (Vaccinated within the past year.)	Yes  No
14. Are your other animals spayed or neutered?	Yes  No
If no, why not?
15. Do you feel you can afford the cost of maintaining this pet for a lifetime?	Yes  No
16. What source of income do you have to make this possible?	Job Public assistance Other
17. Since most shelter animals have unknown medical/health backgrounds, are you prepared to provide and pay for any necessary medical treatment throughout the pet's life?	Yes  No
18. Do you have a regular veterinarian?	Yes  No
If yes, to which clinic do you take your pets?
19. How many children live in your home?
What are their ages?
20. Are all adult members of your family aware that you are adopting a pet?	Yes  No
21. Do any family members have allergies affected by pets?	Yes  No
22. Who will be responsible for taking care of the new pet?
23. How will the pet be cared for if you have to go out of town?
24. Have you had experience training?	Dogs Cats
We have training guides and names of trainers available. Please ask if you need information or help.
25. Have you been to formal obedience classes?	Yes  No
26. Are you familiar with local animal control ordinances for the area in which you reside? A volunteer can provide you with this information.	Yes  No
27. Can we visit your home?	Yes  No
Explain why you want a pet at this time in as many words as you need.  This is an important part of your application.
I certify that the above information is true and accurate to the best of my knowledge and that falsification of this information can be cause for denial of my application or revocation of the contract.
Name
Date
We reserve the right to refuse any adoption.

Alternative Humane Society of Whatcom County
P.O. Box 2321
Bellingham, WA 98227
360-671-7445
info@alternativehumanesociety.org

Copyright© 2004 Alternative Humane Society of Whatcom County