(Please fax this form to 517-265-3837 or email to lhsadoptapet@tc3net.com. Thank you!)

The Lenawee Humane Society reserves the right to refuse adoptions to anyone. Each one of our animals has different needs and we try to place them accordingly. Please understand that completing this application does not guarantee you will be approved.

No animals will be adopted to prospective owners who mislead our staff or fail to provide accurate information on the adoption application. We will hold an animal for an approved adopter for one business day only. You will have the option to Foster an animal for 3-5 days before completing the adoption. This requires a refundable deposit equal to the adoption fee of the animal you are interested in. You must finalize the adoption or return the animal to the shelter at the end of your foster period.

The adoption price is $75.00 if the animal you wish to adopt is already spayed/neutered. If the animal you wish to adopt is not spayed/neutered the adoption price is $60.00 plus a $25.00 sterilization deposit (total $85.00). This deposit and spay/neuter contract is required by Michigan law to ensure all animals adopted from shelters are sterilized. When you have the animal spayed/neutered at your cost and bring in the sterilization contract signed by your vet, the deposit of $25.00 will be refunded within two weeks or you may choose to donate your deposit back to LHS to help us have more animals spayed/neutered. The adoption price includes all vaccinations and tests up to date with the exception of rabies. It does not include sterilization of animals not spayed/neutered at the time of adoption. The Lenawee Humane Society does not have a licensed veterinarian on staff at the shelter, therefore rabies vaccines must be given by your vet if not current at the time of adoption.

Please allow a minimum of 1 hour for us to complete the adoption process. This allows us to ensure our animals are going to loving homes and also to answer any questions you may have. You may fax or email an adoption application to us at any time to get a head start on the approval process.

All adoptions stop at 4:00 PM. We apologize for any inconvenience and will continue the approval process for any submitted applications on our next business day.

(Please Print Clearly)

Name___________________________________________________________________

Spouse/Roommate Name___________________________________________________

Address_________________________________________________________________

City_____________________________________ State_________ Zip______________

Home Phone (____)_________________ Work/Cell Phone (____)__________________

Drivers License #___________________________________ Date of Birth ___/___/____

Occupation_______________________ Spouse’s Occupation______________________

E-mail Address___________________________________________________________

Have you adopted a pet from LHS before? Y / N - Cat / Dog / Both

If Yes, how long ago? _____________________________________________________

Do you still have the pet?___________________________________________________

Have you surrendered any animals to LHS before? Y / N - Cat / Dog / Both

Reason for Surrender______________________________________________________

1. Housing: □Own □Live w/ Parents □Live w/ someone else (ex: roommate)

□Rent in Mobile Home Community □Rent Apartment/House

2. Landlord/Mobile Community Name ______________________________________

Landlord/Mobile Community Phone (____)________________

Comments/Restrictions:_____________________________________________________

________________________________________________________________________

□Adults only □Live Alone □Live w/ parents (need parents permission)

Parents name:_______________________________Phone (____)________________

□Family w/ older children, ages_______ □Family w/ young children, ages_______

□I have children who visit frequently. Their ages are: ____________________________

□Inside the home □Outside the home □Indoor/Outdoor pet

□Crate/Special room inside the home □Free-roaming inside □Free-roaming outside

□Kennel outside □Fenced yard/Invisible fence outside w/shelter

□Tied outside w/ shelter □Unsure/Open to suggestions from shelter staff

The activity level in my home is: □Relaxed □Active □Busy/Hectic

I am…… □home all day (or someone is there) □at home when not at work

□rarely home (sleep there only)

How many hours per day will the pet be alone? _______________________________

□Easygoing (we won’t have many rules) □Assertive (we will stick to the rules)

□Moderate (we may not always follow the rules but will see to well being of pet)

a. size:__________________ d. coat length:___________________

b. age:__________________ e. training level:__________________

c. sex:__________________ f. activity level:__________________

□for a companion □to breed □to guard home/property

□for a gift □to hunt □other ________________________________

Who is your current Veterinarian?

Name/Clinic _____________________________________Phone (__)_______________

What will happen to your pet in case of emergency or if you go on vacation? ________________________________________________________________________

Name/Clinic _____________________________________Phone (__)_______________

□return the pet to the shelter □give the pet away

□keep the pet outside □nothing – I’m prepared for this possibility

□other (please explain) _________________________________________________

□return the pet to the shelter □give the pet away

□keep the pet outside □nothing – I’m prepared for this possibility

□crate the pet while not at home □ask my veterinarian for tips or advice

□other (please explain) _________________________________________________

□return the pet to the shelter □give the pet away

□keep the pet outside □nothing – I’m prepared for this possibility

□crate the pet while not at home □ask my veterinarian for tips or advice

□other (please explain) _________________________________________________

Please list two or more character references that can tell us how you are with animals. Please list only one family member and you may not list a person visiting the shelter with you today.

_______________________________________________________________________

Questions for our staff?____________________________________________________

Comments_______________________________________________________________

________________________________________________________________________

________________________________________________________________________

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