Best Friends Humane Society in Worth County
Adoption Application
(Revised 07-20-12)
This application must be completed prior to adoption from the Best Friends Humane
Society. The Shelter Staff strives to place our animals in permanent, responsible
homes, while at the same time, matching families with a pet suitable for you home and
lifestyle.
NOTE: Providing false information anywhere on this form will result in the
forfeiture of all adoption fees and any animal(s) adopted.
Please Print
Date________________
First Name:_______________________ MI:____ Last Name:__________________________
Current Address:_________________________________________________________________
Mailing Address (if different)_______________________________________________________
Home Phone: ___________________________ Mobile Phone: ___________________________
Email Address: ____________________________________________________________________
How/Where did you hear about Best Friends? _____________________________________
1. How long have you lived at the above address? _______________________________
2. Please check any of the following reasons you want to adopt a pet:
Family Pet ________ Child’s Pet ________ Watchdog ______ Companion _________
Hunting Dog _____ Barn Cat/Mouser ______ Companion for another pet _______
Other (Explain)_____________________________________________________________
3. What is your source of income? ______________________________________________
4. Are you 18 years of age or over? Yes_____ No_____
5. Are you interested in adopting for yourself or someone else? __________________
6. Do you live in a: House ____ Apartment _____ Other _______________
Best Friends Humane Society in Worth County – PO Box 5894 – Sylvester, GA 31792
Shelter Phone 229.777.7774 – Email [email protected] – Website www.bfhsworth.com
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7. Do you: Own your home: _______ Rent: ______ If you rent, does your lease allow
pets? Yes ____ No _____
8. What is your landlord’s name or the name of your apartment condo complex?
______________________ Phone number? ________________
9. How many people live in your household? ______ Do all members know that you
plan to adopt a pet? _____________________
10. What are the ages of all children in your household? _________________________
11. Who will be responsible for taking care of your pet? __________________________
12. If adopting a dog or puppy, what procedures will you use for housebreaking?
______________________________________________________________
13. If adopting a dog or puppy, how will you handle chewing or destructive
behavior? _______________________________________________________________
14. Have you ever adopted a pet from any shelter before? Yes ____ No ____
15. How many pets have you owned in the past 5 years? Dogs ____ Cats ____ Where
are those pets now (be specific)
_______________________________________________________
Please list each animal’s name, age, sex, and breed on this form.
16. Have you ever turned in an animal to a shelter? Yes___ No___ When___________
Why __________________________________________________________________________
17. Do the pets in your household live indoors or outdoors? ______________________
18. Are the pets in your household up to date on all their shots? Yes ____ No ____
If no, explain: ______________________________________________________________
19. Are the pets in your household spayed or neutered? Yes___ No___ If no,
explain: ____________________________________________________________________
Best Friends Humane Society in Worth County – PO Box 5894 – Sylvester, GA 31792
Shelter Phone 229.777.7774 – Email [email protected] – Website www.bfhsworth.com
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20. What is the name of your Veterinarian, or Veterinary Clinic: ___________________
21. Would you object to having your new pet spayed or neutered? Yes ____No ____
if yes, why? ______________________________________________________________________
22. Are you willing to go to the expense and trouble of taking your new pet to a
veterinarian for full preventative and medical care AT LEAST once a year?
Yes ___ No___
23. Will your new pet live inside____ or outside_____? Where will your pet sleep?
_______________________
24. Is there a yard available at your residence? Yes ___ No ___ Is the yard
completely fenced? Yes ___ No ___
25. Is there a dog house? Yes ___ No___ Will your pet ever be tied or chained?
Yes ___ No ___
26. What do you plan to do with your pet when you go on vacation or travel?
________________________________________________________________________________
27. If you have to move, what would you do with your pet? _______________________
28. What if your new residence didn’t allow pets? _________________________________
29. Would you object to an authorized representative of the Best Friends Humane
Society in Worth County inspecting the animal and premises where the animal is
being kept? Yes ___ No ___
Information checked by? ____________ Approved ______ Declined ________
Reason for refusal (be specific) ____________________________________________
Best Friends Humane Society in Worth County – PO Box 5894 – Sylvester, GA 31792
Shelter Phone 229.777.7774 – Email [email protected] – Website www.bfhsworth.com
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