Adoption Application November 15, 2016 dbrickhouse Blog Adoption Application Adoption Application Date* Before adding a new pet, please consider the following questions:* Do you have space for the animal? Does everyone in your home want a new pet? Will you have plenty of time to spend with your pet? Can you afford vet visits and yearly check-ups? Have you considered the potential that an animal may damage furniture or carpet? Are you allowed to have a pet in your condo, apartment, or rental property? Who will care for your pet when you are out of town? Are you willing to care for an animal for the rest of its life? Checking these items will confirm YES for each question.Name* First Last Spouse's Name First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*Email* Emergency Microchip Contact - Someone Not in Household* First Last Please give us a name and number of someone we can contact in case we are unable to reach you. Emergency Contact Phone Number*Are you at least 19 years old?* Yes No What type of animal are you looking for? Dog Cat Have you adopted from us before?* Yes No Are there other animals in your home?* Yes No Where do you plan on keeping your pet?* Inside Outside Both If adopting a cat, do you plan to declaw? Yes No When outside, how do you plan on confining your pet?* Fence Leash Tied/Chained Free Roam Other If other, please explainBehaviors that would not work in your household are:*By submitting and signing this application, you understand...*1. Before taking a pet home, I will be required to sign a legally binding adoption contract. 2.Shelby Humane Society reserves the right to refuse an adoption. 3. It is not possible for Shelby Humane Society to guarantee the health or temperament of any animal. 4. The adoption fee is non-refundable.