The Humane Society Of Wickenburg Adoption Application
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1
2THE HUMANE SOCIETY OF WICKENBURG
4000 Industrial Road
Wickenburg, AZ 85390
928-684-8801
ADOPTION APPLICATION
To ensure that we help you find the most appropriate animal for you and your family, please fill out this
application as thoroughly as possible.
CONTACT INFORMATION
NAME:_________________________________ ADDRESS:___________________________________________________________
EMAIL:_________________________________ PHONE: (____) ______________ SECONDARY PHONE: (____) _______________
Type of Residence: [
] Own Home [
] Own Condo [
] Rent Home [
] Rent Condo [
] Rent Apt. [
] Rent Mobile Home [
] With Relatives/Friends
DOG
CAT
Reasons for Wanting a Dog:
Reasons for Wanting a Cat:
[ ] Companionship
[ ] Company For My Dog / Cat
[ ] Companionship
[ ] Company For My Cat / Dog
[ ] Protection
[ ] Gift For Someone
[ ] Mouser / Barn Cat
[ ] Gift For Someone
[ ] Indoor
[ ] Outdoor Yard Only
[ ] Indoor
Where Will Your Dog Be:
Where Will Your Cat Be:
At Night:
At Night:
In The Daytime:
In The Daytime:
When Alone:
When Alone:
Time Alone Daily:
Time Alone Daily:
Exercise Your Dog:
What will you give your Cat:
[ ] cat toys
[ ] Daily Walks
[ ] Dog Park
[ ] Yard Only
[ ] litter box
Describe Your Fence:
[ ] scratching posts
[ ] 4 Ft.
[ ] 6 Ft.
[ ] Varied Height ________________
[ ] bed
[ ] Chain Link
[ ] Wood
[ ] Field Fence
[ ] Cinder Block
[ ] cat tree
Outdoor Shelter:
Other:
QUALITIES THAT I WOULD LIKE MY PET TO HAVE:
[ ] Likes Children
[ ] Likes Dogs /
Cats
[ ] OK Alone / Independant
[ ] Low Shedding
[ ] Accepting of Strangers
[ ] Protective
[ ] Affectionate
[ ] Playful / Mellow
[ ] Not Fearful / Aggressive
[ ] Prior Obedience Training
[ ] Housetrained / Litter Box Trained
[ ] Quiet
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