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HOURS: Monday - Friday 11:00 a.m. to 5:00 p.m. • Saturday 11:00 a.m. to 3:00 p.m. • Closed Sundays and Major Holidays
Cherryland Humane Society - Home
Adopt a Dog
BENTLY
Male 1 yr.

Adopt a Cat
GRAY
Female 2 yr.

 

Adoption
Application Form

Upon arrival at the Cherryland Humane Society, all pets are evaluated by our staff. All dogs and puppies receive an evaluation status, which is listed on each cage. We ask that you complete the following form prior to adoption to ensure that the proper pet is placed into your household. Please complete and print the form and bring it with you to the shelter. If you wish to let us know about your particular interest, please use this form to notify us.

Date
Name
Home phone
Work phone
Address
City
Zip Code
Residence Homeowner    Renter
Landlord name
Landlord phone
Reason for adoption
Have you adopted from CHS before? Yes   No
If yes, where is that pet now?
Will the pet be indoors at all? Yes    No
Regarding your current pets:
Are they spayed/neutered? Yes   No
Up to date with all shots? Yes   No
Do you have a veterinarian? Yes   No
Are you willing to incur the expense of routine veterinary care, typically $50 - $100 per year?
Will you provide veterinary care? Yes   No
If you move, will you take your pet with you? Yes   No
What will you do with your pet during vacations or emergencies?
Would you object to an authorized CHS rep visiting the pet to inspect its living conditions? Yes   No
Please let us know if you have any specific requests regarding the pet you wish to adopt.
Species Cat   Dog
Breed
Age range
Weight range
Gender Female   Male
Mixed breed Yes   No
Specifics or notes
Complete the following for dog and puppy adoptions only.
Are you or any household members first time dog owners? No   Yes
(if yes, avoid B pets)
Are there any preschool children in your household? No   Yes
(if yes, avoid C pets)
Are there any other dogs/cats in your household? No   Yes
(if yes, avoid D pets)
Are there any elderly or disabled persons in your household? No   Yes
(if yes, avoid E pets)