Pet Adoption Application (Page 3 of 3) in pdf

Pet Adoption Application Page 3

The Shelter cannot guarantee that any adopted animal is free from heartworms: Therefore it is

advisable that anyone who adopts a dog should take it to his Vet for a checkup. Any expense will be

paid by the adopter.

Dog & cats will be adopted as household pets only, where they will be kept as part of the family and

will not be chained. Pets may not be adopted as gifts to someone outside the immediate family.

If, for some reason, the animal is incompatible or dies within 14 days, we will replace the animal, but

there will be no refund. Proof will need to be provided in case of death.

_________________________________________ _________________________________________

Signature of applicant

G C H S

Application Approved: yes_______ if no state reason

___________________________________________________

Supervisor’s Signature if

disapproved___________________________________________________________________

Date

disapproved:___________________________________________________________________________

10/06

Pet Adoption Application Page 3