Adoption Application

Thank you for considering one of our pets for adoption. An approved adoption application is required to adopt. Applications are reviewed in the order they are received and are valid for 3 months. An animal can be “held” for an applicant until the end of the following business day, but only if the application for that animal has been approved.

First Name

Last Name

Street Address

City, State, Zip Code

Driver License/ID Number

Your Age (applicant must be at least 18 years old to adopt)

If any children live at the address, please list their ages below or type "none."

Primary Phone Number

Other Phone Number

Do you own the property at the address above?

YES, my name is on the deed.

NO, I do not own the property.

If NO, please provide the name and phone number of the property owner or manager below.

What is the name of the animal are you interested in adopting?

Do any dogs or cats currently live at the address above?

Yes

Name and phone number of veterinarian where current pets have records:

If YES, please list the name, species, breed, sex, age and current vaccines for each pet.

By submitting this form, I give the Wayne County Humane Society permission to make inquiries about any and all records and information provided on this form, including all current and previous veterinary records and information. I understand that the Wayne County Humane Society has the right to question and refuse all adoptions.