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Adoption Application (PDF format)
or apply online
Spencer County Animal Shelter - Adoption Application
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Indicates required field
Requirements - check boxes that apply.
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I understand that vet care for my adopted dog can cost over $1,000 per year.
Depending upon the particular animal, dogs can live to be as old as 17 years of age. I understand this and am committed to care for my adopted dog for the length of his/her life.
I understand that there is an adoption fee and agree to pay that fee.
I verify that everyone living in my home is in agreement to adopt a dog at this time.
I am 21 years of age or older. I understand that the information in my application to Spencer County Animal Shelter is confidential.
I understand that Spencer County Animal Shelter has the right to decline my application.
I understand that if any of the information on this application is misrepresented, my application will be automatically denied.
Name of dog you wish to adopt
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See adoptable dogs on the Home page of the site.
Your Name
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First
Last
Home Phone Number
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Cell Number
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Email
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Your Address
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Line 1
Line 2
City
State
Zip Code
Country
How long have you lived at this address?
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Describe Yard - specify whether it is fenced.
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Size. Is it fenced? Type of fence. Height of fence.
If not fenced, how do you plan to contain the dog when outside?
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List Family Members in Home
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Please put names, ages and allergies for each person living in the home where the adopted dog will be.
Where will the dog be kept when you are not at home?
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Where will the dog be kept when you are at home?
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How many hours would the dog be left alone?
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Where will the dog sleep?
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How will the dog be exercised?
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Where will the dog relieve itself?
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What type of dog are you hoping to adopt?
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Breed, age, size, gender
What are you looking for in a dog?
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family pet, playmate for current dog, running partner, etc.
Type of home: apartment, trailer, house, etc.
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Rent, Own, Live with Someone
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Are Dogs Permitted?
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Size/Breed Restrictions
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Are you willing to housebreak a dog? Train a dog? Would you hire a trainer or go to training school? Does anyone in the household have experience training dogs? Please explain.*
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Is anyone in the home afraid of dogs?*
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List all pets living in your home
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Type (Breed), Age, Altered, where it's from, personality, how it gets along with other animals, etc.
Provide personal references of two (2) people who are not related to you.
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List names, cell phone numbers, home phone numbers, and relationship to you.
Provide one (1) reference of a person to whom you are related.
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List name, cell phone number, home phone number, and relationship to you.
Veterinarian Reference
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Name, address, phone number.
Additional Information that you would like us to know.
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Digital signature verifying all information on this form is true to the best of your knowledge.
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Submit
