Adoption application
The Adoption Form below is for those that want to
fill it out online and send it via email.
______________________________________________________________________________
The Adoption Form below is for those that prefer
to print it and fill it out at their leisure.
Copy and paste the form below into a new Word document.
Then "Print it", fill it out and bring it to the Shelter.
Call first. 715-478-2098
FOREST COUNTY HUMANE SOCIETY
701 Industrial Parkway
PO Box 57
Crandon WI 54520
Phone: (715) 478-2098
Email:
Federal Tax ID# 39-1812068
Full Name (First, M.I. Last) ______________________________________________________
Address ________________________________ City ____________________ State _______ Zip ______
Email Address___________________________________
Phone # ________________
Employer _______________________________
Work phone ________________________
Spouse/Roommate ___________________________________
Employer __________________________ Employer's Phone _______________________
Veterinarian ________________________________ Vet. Phone ____________________
Please provide two non-related references:
Name and Relationship ______________________________________________
Phone _____________________
Name and Relationship ______________________________________________
Phone _____________________
Thank-you for your interest in adopting a pet from us. The following application will help us
assist you in the selection of a new pet. Please fill in all that applies to you.
I am interested in adopting (Name and Breed): _______________________________
Do you own or rent your home? (X one):Own____ Rent____
If rent, Landlord Name and Phone Number: _______________________________________
How many members in your household? Adults____ Children (over ten) ____ (under ten) ____
Have you ever surrendered an animal to a shelter before? Yes ____ No ____ If Yes, please explain
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
How many hours a day will the animal be left alone? _____
Where will the animal be kept when home alone?
______________________________________________________
Do you own any other pets at this time? Yes____ No____ if Yes please list below:
1. Pet's Name & Breed _________________________________________________
Altered? Yes____ No____ Age____
2. Pet's Name & Breed _________________________________________________
Altered? Yes____ No____ Age____
3. Pet's Name & Breed _________________________________________________
Altered? Yes____ No____ Age____
4. Pet's Name & Breed ________________________________________________ _
Altered? Yes____ No____ Age____
Are your pets current on their rabies and distemper vaccinations? Yes____ No____
Please READ each of the following and sign below to acknowledge you agree with these statements.
1. I am at least 18 years old.
2. I have consent to adopt an animal from all adults in my home.
3. I have verifiable identification showing my present address.
4. I have a written letter of approval from my landlord to have an animal in my home.
5. I agree to not let the animal run at large or become a public nuisance and am aware of leash and licensing laws in my town/county.
6. I understand that even though The Forest County Humane Society does their best at determining the
breed and age of an animal, we cannot guarantee the accuracy of that determination.
7. I understand that the Forest County Humane Society has the right to accept or deny my request and that
although the Forest County Humane Society will give your profile full consideration, the animal will go to
the family that can provide the best home.
By signing below, I certify that the information I have given is true. I realize that any misrepresentation of facts may
result in my losing the privilege to adopt a pet. I understand that the FCHS has the right to deny my request to adopt an animal for any situation that would becontrary to the shelters policies, in violation of state or local ordinances
or not in the best interest of the animal. I authorize the investigation of all statements in this application.
I also authorize my veterinarian to release any information requested by the FCHS.
Signature: _________________________________________
Date:________________________
Approved by___________________________________ Case number: _______________
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1. Click on the Word Document Icon below.
2. Once you have it open in Word, CLICK on "enable editing".
3. Fill out the form.
4. Follow further instructions on document page