Adoption Application | National Humane Education Society

Personal Information

Please know that each animal taken into the BAAC receives their initial vaccinations, de-wormings, are microchipped and are spayed/neutered before adoption.

First Name *

Last Name *

Today's Date: *

Email Address *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

How long have you lived at above address?

Home Phone

Work Phone

What is your contact preference? *EmailPhoneEither

Are you a member of the National Humane Education Society? *YesNo

How did you become aware of us?

Housing Information

If you live in an Apartment, on what floor do you live?

Do you have a yard? *YesNo

Size of yard?

Is your yard fenced? *YesNo

Type/height of fence?

Do you own or rent your home?OwnRent

If rent, please upload an image of your landlord's pet policy. Upload File Here:

No file chosen

If you are renting, does your lease allow pets? *YesNoN/A

How many adults are in your household?

How many children are in your household?

Ages?

Is there anyone home during the day? *YesNo

Please list what hours you would be out of the home on an average day:

Pet Information

Please list information on current and previous pets.

Is this your first experience with a pet? *YesNo

Currently Owned Pets

Do you currently own other pets? *YesNo

If yes, are they up to date with their vaccination boosters? *YesNo

Medical HistoryPlease attach most current medical history of each animal (optional):

No file chosen

Currently Owned PetsPlease provide information on current pets in household.

Pet Name

Species

Breed

Gender

Altered

Age

Healthy

If no, explain (ie. chronic illness, diabetes, cancer, etc.)

Do you have any declawed cats? *YesNoN/A

Do you have dogs with cropped ears or docked tails? *YesNoN/A

What are you interested in adopting? *PuppyDogKittenCat

Any specific breed or mix?

What age range? *Under 1yrUnder 2yrs2-5yrs5yrs or older

What size? *Under 15 lbsUnder 30 lbsUnder 50 lbs

Other preferences?(i.e., calm, active, type of coat):

If you have any specific animal(s) in mind, please list name(s):

Please list your reason(s) for wanting to adopt an animal:

Where will this pet be primarily living? *IndoorsOutdoors

Where will your pet sleep at night?

Type of exercise are you planning to provide a dog?

How often do you plan on exercising your dog?

Previously Owned Pets

In addition to your current pets, please list any other animals that you have owned in the past five years and what happened to them:

Previously Owned PetsPlease provide information on previous pets in household.

Pet Name

Species

Breed

Gender

Altered

Age

What happened?

When?

References

Who is your veterinarian?

Veterinarian's Phone:

Please provide your landlord's Name:

Landlord's Phone:(Please note: We require confirmation of approval from your landlord before showing animals)

Other References:

Agreement

NHES Adoption Agreement *If you adopt an animal from the BAAC, will you agree to the following: Agree to provide proper food, fresh water, weatherproof, clean shelter and humane treatment to the animal Agree to keep my pet on my property or within my control at all times Keep the adopted pet current on all health check-ups & vaccinations Purchase a properly fitted collar and license (if required) for your specific area Agree not to tie or chain the pet as a primary means of confinement Give a reasonable amount of time to allow the pet to adjust to your homeI agree

Did you have a specific amount of time in mind for adjustment?

Do you have any other questions or concerns?

For what reasons do you feel you might need to return an animal?