CCHS Adoption Application

Adopting a pet is a big step and requires your undivided attention and love. Most of our pets are rescued from shelters in the greater DFW area, and are usually set to be euthanized. We pull them and pray people like you will help us in our cause, to provide loving and caring homes for animals that give you pure unconditional love. We take our pets seriously and put careful thought and attention to the homes they go to. Our goal is to find a forever home for these loving animals. From the bottom or our hearts we thank you!

**Home checks are done before placement**

Name of the pet you are interested in adopting:

First Name:

Last Name:

Phone Number:

E-mail:

Street Address:

City:

State:

Texas Alabama Alaska Arizona Arlansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code:

Residence Type:

Select Drop Down Single Family Residence Condominium / Townhome Apartment Complex Mobile Home / Trailer Home

How many people live in your household?
Adults:

1 2 3 4 5

Children:

0 1 2 3 4 5

What are the ages of the Adults?

What are the ages of children under 18?

Do all the Adults in the home know you are adopting a pet?

NA Y N

Do you own the home you are living in?

NA Y N

If you are renting can you provide proof of pet deposit?

NA Y N

Describe the type of fencing you have? IE: None / 6ft Wood Fence / Wrought Iron Fence
Why are you looking for a pet? IE: Companion / Guard Dog / Gift / Hunting

What other pets have you had and what happened to them? Just let us know a little about your pet history and why they are / are not with you anymore. Were they indoor or Outdoor?

Are your pets up to date with their Vaccinations?
Bordetella:

NA Y N

Rabies:

NA Y N

DHPPC:

NA Y N

Are your pets on HW Preventatives?

NA Y N

Are your pets Spayed/Neutered?

NA Y N

Vet Contact Information: Your Vet's Name / Your Vet's Phone Number

How many Hours a day will your pet be home alone?

0 1 2 3 4 5 6 7 8 9 10

Where will your pet be kept during the day? Hold "Ctrl" button to select multiple:
Crate Back Yard Take to Work Let Roam Free in house Garage Utility / Bathroom Dog House Day Care facility

Where will your pet be kept during at night? Hold "Ctrl" button to select multiple:
Crate Back Yard Take to Work Let Roam Free in house Garage Utility / Bathroom Dog House Day Care facility

What behaviors can you tolerate with a new pet? Hold "Ctrl" button to select multiple:
Chewing Digging Barking Gets on Furniture Potty Accidents Begging

If no to any behavior, briefly explain how you would handle the problem?
Solution: Enter your solution to an unwanted behavior

What do you do with your pet when you leave town? Hold "Ctrl" button to select multiple:
Neighbor/Friend/Family Crate Back Yard Take to Work Let Roam Free in house Garage Utility / Bathroom Dog House Day Care facility

Anyone in your home allergic to cats / dogs?

NA Y N

What happens to the pet if you have to move?

Re-Home Take With Me

How did you hear about our Organization? Enter source

Would you be interested in fostering for CCHS?

NA Y N

Does anyone in your home require mental or physical care?
Briefly explain if applicable

By checking this box I certify that all information is truthful and accurate.

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What day comes after Saturday?