“Shall we all open our heart to be a forever home for lost pets.” — Martha Steward

Adoption Application

Once you have completed an application it is on file for the rest of the calendar year. See a pet you want to put a hold on? Give us a call at 574-848-4225.

Adoption

WELCOME, AND THANK YOU FOR CONSIDERING ADOPTION OF A SHELTER COMPANION!
This application is designed to help determine what will be in the best interest of the animal and to assist potential adopters in finding a companion that is most compatible with their lifestyle.
Please understand that the animal's welfare must and will always be our foremost consideration. Therefore, the Humane Society reserves the right to approve or deny an adoption.

TERMS AND CONDITIONS FOR ADOPTION (PLEASE READ CAREFULLY & INITIAL EACH) AS A POTENTIAL ADOPTER, I UNDERSTAND THAT:
The animal(s) I adopt cannot be given away without the permission of the Humane Society of Elkhart County, and if I am unable to keep the animal(s), it/they are to be returned to the Humane Society of Elkhart County.
The adopter must meet the animal prior to adoption.
I must be able to provide necessary time and financial resources for appropriate training, medical treatment and proper care for the lifespan of the animal. The Humane Society will NOT reimburse me for any future veterinary expenses, including the required wellness exam. The Humane Society will not replace or provide a refund if my new pet does not get along with my current pet(s). A wellness exam may be required prior to adoption. If I am adopting a dog and I currently own a dog or dogs, a meet and greet appointment may be required and/or requested before I adopt the new dog. I must adhere to all laws and ordinances and in some cities, may be required to purchase a license for my companion animal.

ADOPTION APPLICATION We are delighted that you are interested in adopting a companion animal from us! Due to State laws regarding ownership, potential adopters must be 18 years of age or older. It may take up 1-2 business days to process your application. In order to help us be effective in processing your application, please fill out your application completely and truthfully.

TERMS AND CONDITIONS FOR ADOPTION (PLEASE READ CAREFULLY & INITIAL EACH)
(PLEASE READ CAREFULLY & CHECK EACH) By checking below you are agreeing to these terms.
AS A POTENTIAL ADOPTER, I UNDERSTAND THAT:*
- If I am unable to keep the animal(s), I adopt, I may returned it to the Humane Society of Elkhart County or it may be rehomed with the permission of the Humane Society of Elkhart County.
- Adopter must meet the animal prior to adoption.
- I must be able to provide necessary time and financial resources for appropriate training, medical treatment and proper care for the lifespan of the animal.
- The Humane Society will NOT reimburse me for any future veterinary expenses, including the required wellness exam.
- The Humane Society will not replace or provide a refund if my new pet does not get along with my current pet(s).
- A wellness exam may be required after adoption.
- If I am adopting a dog and I currently own a dog or dogs, a meet and greet appointment may be required and/or requested before I adopt the new dog.
- I must adhere to all laws and ordinances and in some cities, may be required to purchase a license for my companion animal.
APPLICANT'S INFORMATION
First Name*
Last Name*
Email*
County*

Please List Only One Cat of Interest

Please List Only One Dog of Interest

Please List Only One Other Animal of Interest

* Email required in order to receive Pet Insurance Policy included with your adoption. By providing your email you consent to Pethealth, Inc. collecting and using your personal information for the purpose of contacting you with commercial electronic messaging and telephone communications.)
Address*
Street Address City State ZIP Code
Have you lived at this address at least 5 years*
- Yes
- No
Please provide your previous address.
Address
Street Address City State / Province / Region ZIP / Postal Code
Home Phone
Work Phone
Cell Phone
Select what type of home you live in:*
- House
- Apartment/Condo
- Mobile Home

Please list ALL individuals, INCLUDING YOURSELF, currently living in your household:*

FULL NAME (FIRST M.I. LAST)	RELATION TO APPLICANT	Age	Date Of Birth (IF 18+ YEARS)	DRIVER'S LICENSE/STATE ID # (IF 18+ YEARS)

Why do you want your new pet? (Check all that apply)
- Inside Pet
- Outside Pet
- Breeder
- Hunter/Mouser
- Companion
- Companion for present pet(s)
- Guard Dog
Guard Dog (Explain):
Where will your new pet be kept when you are not home?
- Inside Home
- Outside Home
- Work
- Basement
- Patio/Porch
- Indoor Crate
- Outdoor Kennel
- Chain/Tie-out
- Other
Other (Explain):

Please list all cats, dogs and small animals currently living in your household

Name	Type (Cat, Dog, Small Animal)	Breed	Sex	Indoor or Outdoor	Age	Spayed / Neutered (Yes-No)

Are your current pets up to date on their Rabies vaccination?
- Yes
- No
If No, please understand that according to state law it is required that your current pets be vaccinated for Rabies.
If approved for adoption, I would like to be enrolled in the Petco/PetPal rewards program.
- Yes
- No
How did you hear about us?
- Website
- Facebook
- Television
- Newspaper
- Pet Store
- Other Adopter
- Pre. Adopted
- Volunteer
- Other
Other (Explain):
By submitting (Digital Signature):*
I CERTIFY THAT I UNDERSTAND AND AGREE TO THE HUMANE SOCIETY OF ELKHART COUNTY'S TERMS AND CONDITIONS FOR ADOPTION.
I CERTIFY THAT I UNDERSTAND AND AGREE TO THE HUMANE SOCIETY OF ELKHART COUNTY'S TERMS AND CONDITIONS FOR ADOPTION.
I FURTHER CERTIFY THAT THE INFORMATION GIVEN IN THIS APPLICATION IS COMPLETE AND TRUE.
I UNDERSTAND THAT ANY WITHHELD, INCOMPLETE OR FALSE INFORMATION MAY RESULT IN NULLIFYING THIS APPLICATION.
Date
MM slash DD slash YYYY
CAPTCHA

“Shall we all open our heart to be a forever home for lost pets.” — Martha Steward

Once you have completed an application it is on file for the rest of the calendar year. See a pet you want to put a hold on? Give us a call at 574-848-4225.

Adoption

WELCOME, AND THANK YOU FOR CONSIDERING ADOPTION OF A SHELTER COMPANION!

TERMS AND CONDITIONS FOR ADOPTION (PLEASE READ CAREFULLY & INITIAL EACH) AS A POTENTIAL ADOPTER, I UNDERSTAND THAT:

TERMS AND CONDITIONS FOR ADOPTION (PLEASE READ CAREFULLY & INITIAL EACH)

APPLICANT'S INFORMATION

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