Special Adoption Application

 

WHS Logo 150

The Wisconsin Humane Society
Special Adoption Application

 

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Section I

We are committed to finding the best home for every animal entrusted to our care and ensuring that the animal you are interested in adopting is best suited to you, your home and lifestyle; therefore, we would appreciate your providing us with the following information. We review each application carefully to ensure the best fit for each animal and guardian.

 

  Please tell us about yourself:

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Name:

 

 

 

 

 

         

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City/State/ZIP:

 

    

 

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Section II

Please complete this questionnaire for the household in which your companion animal will reside.

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(Maximum response 255 chars, approx. 5 rows of text)

   


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Question - Required - Please check all that apply. Is the dog being adopted as a:
Please make between 1 and 8 selections from the choices below.

 

(Maximum response 255 chars, approx. 5 rows of text)

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  Section III
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  Please provide additional information about these animals:
   


   


   


   


   


 


   


   


   


   


   


 


   


   


   


   


   


 


 

 

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  Section IV
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Section V

I certify that I am at least 18 years of age and the information I have given is true. I recognize that the misrepresentation of facts may result in my losing the privilege of adopting an animal. I authorize any and all verification of statements made in the application and I understand that the Wisconsin Humane Society has the right to deny my application.

I am fully aware that I am adopting a living creature and as such, the Wisconsin Humane Society is unable to guarantee the health of the animal.

If this animal becomes ill, I certify that I am financially and emotionally prepared to treat this animal at my own expense.

 

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