Dog & Cat Adoption Application – Dunn County Humane Society

Please complete all fields of this form to the best of your ability. If you prefer to print the application and fill it out offline, you can download the Cat Adoption Application here and the Dog Adoption Application here. Thank you!

Adoptable Pet Type:*
- Cat
- Dog
Adoptable Pet Name:
Applicant's Full Legal Name:*
First Middle Last
Applicant's Date of Birth:*
MM slash DD slash YYYY
Co-Applicant's Full Legal Name:
First Middle Last
Co-Applicant's Date of Birth:
MM slash DD slash YYYY
Address:*
Street Address Address Line 2 City State ZIP Code
How long at current address?*
Main Phone:*
Alt. Phone:
Email*
Live in a:*
- House
- Apartment
- Condo
- Mobile home
- Townhome
Do you Rent or Own?
If living in a mobile home that sits on land not owned by the applicant then identify the Mobile Home Park:
Have you spoken to your landlord about getting a pet?*
- Yes
- No
Landlord First/Last Name:*
Landlord's Phone:*
Are you over the age of 65 or a military veteran (active, retired, or honorably discharged**)?
- Yes
- No
**We have a program to help subsidize adoptions by seniors (65+) and military veterans (active, retired, or honorably discharged). This program offers a $50 discount once per year and cannot be combined with other offers and does not apply to adoptions at Petco, PetSmart, or Angel’s Pet World.
Including you, how many people live in your household?
What are their ages?
Have you applied to adopt from DCHS?
- Yes
- No
If yes, when?
Have you ever brought an animal to a shelter?
- Yes
- No
If yes, when?
Have you ever given an animal to another person?*
- Yes
- No
If yes, please explain.*
Have you spent time with the pet?
- Yes
- No
Have you spoken to a staff member, if so who?
Are you committed to spend 12+ years providing health care, food, grooming & attention to the pet?
- Yes
- No
Future or Recent Life Events:
- Baby
- Moving
- Vacation
- Divorce
- Laid Off
- N/A
If you move in the future, what will you do with the pet?
Why do you want a pet?
Who will be the pet’s primary caretaker?
The primary caretaker is:
- Employed Full Time
- Employed Part Time
- Retired
- Stay Home
- Student
How many hours will the dog be alone without human companionship per day?
This pet will be:
Will you declaw the cat?*
Declaw Reason:*
It may take the pet a month or longer to adjust to your home. Are you prepared for this adjustment period?
What problems would make you want to return the pet?
(Hold down the CTRL key while clicking to choose more than one selection)
What types of pets have you owned during the past 5 years? (Please list animals currently living with you also.)
Cat / Dog Name Gender Spayed / Neutered? Breed Age Kept Indoors / Outdoors? Still Own? (Y/N)

(Click the + Sign to Add More Pets)
If you no longer have the above pet(s) please explain why:
Are your pets up to date with vaccinations?
- Yes
- No
- I don't know
Your Current Vet:
First Last
Your Current Vet's Phone:
When adopting an unneutered or unspayed pet from DCHS, it is required to have the pet spayed/neutered. Are you prepared financially and willing to comply with this policy?
- Yes
- No
Is there any other information you wish to share or feel should be considered when processing your application?
*If there are other adults in the household besides the applicant/co-applicant, please list their full legal names and dates of birth here:
First Name: Middle Name: Last Name: DOB:

(Click the + symbol to add more than 1 person)
Consent*
I agree to the the following statement:
The undersigned applicant(s) hereby grants the Dunn County Humane Society, Inc. (DCHS) permission to confirm any information provided in this application with any third party source including landlords, veterinarians, law enforcement, online sources, property records, etc. The information obtained will be held in confidence and used only by the DCHS for purposes of this adoption application. The DCHS does not discuss application decisions with anyone except the listed applicant or co-applicant. The applicant(s) certify that all the information on this application is true and complete and understand that if any false information, omissions, or misrepresentations are discovered, the application may be rejected. The information on this application is considered unchangeable, once it is submitted for consideration. Reapplying with changed or different information voids all applications from consideration.

It is expressly understood that this adoption application is the sole property of the DCHS and the DCHS reserves the right to deny any adoption at its own discretion. Applying does not guarantee approval nor does it reserve any animal from going to another applicant.
Applicant's Signature*
You can type your name here if completing online.
Date*
MM slash DD slash YYYY
Driver's License State:*
Driver's License Number (required):*

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