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2. Thank you for considering adopting a pet from the Pet Adoption Center. To better serve your needs and that of the animals in our care, carefully read and answer the following questions to help guide our conversation. Completing this application might take several minutes, but it is our intention that your relationship with your new pet lasts many years. Your application will be kept on file for 90 days. We reserve the right to deny any adoption if you are under the influence of drugs or alcohol.
4. I agree to answer each and every question related to this adoption truthfully. I understand St. Charles County Division of Humane Services relies on this application in making decisions as to the permanent place of animals in its care. The information provided herein is essential in ensuring all animals are placed in the best possible homes. In signing below I agree that I am at least 21 years of age and attest that all questions related to this adoption are answered fully and truthfully to the best of my knowledge.
6. Name (Signature of Applicant)*
7. Date*
9. Application
11. Name*
12. Email Address*
14. Phone Number*
15. Alternate Phone Number
17. Address*
19. City*
20. State*
21. Zip*
23. What address will the animal live at?*

    1. Same as above
    2. A different address
25. Address
27. City
28. State
29. Zip
31. I am interested in adopting:

    1. A cat
    2. A kitten
    3. A dog
    4. A puppy
    5. Another animal
33. Animal(s) I am interested in adopting:*

    Provide the animal number or animal name on the line above. Staff will make its best effort to schedule an appointment at a convenient time that allows you to look at/interact with all available animals.
    
    Please note that an animal that you list may be adopted before you confirm an appointment. Staff cannot hold animals from adoption prior to your appointment.

35. If you are renting where you reside, please list the name and daytime phone number for the landlord/manager and detail any rental restrictions.

    We welcome adopters who rent or live in an apartment or condo. We want to alert you that some landlords and management companies have size and breed restrictions, limits on number of pets, and/or require pet deposits or additional fees.

37. How many pets do you currently own?*
38. Are the pets you own spayed/neutered?

    1. Yes
    2. No
    3. Does not apply
40. Tell us about human members of the new pet's household (e.g. number of adults/seniors/young children/teens).*
42. Tell us about pets at home (age/breed/crate-trained when not at home or loose).*
44. If you are adopting a cat or kitten, do you want a FELUK/FIV test ($15 non-refundable)?

    1. Yes
    2. No
Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit

* indicates a required field