**Please answer all questions. Failure to complete the application can
                               result in refusal of adoption.**
THE LOGAN COUNTY HUMANE SOCIETY
        550 SPORTSMAN CLUB ROAD
                   PO BOX 1001
    RUSSELLVILLE, KENTUCKY 42276
                     270-726-2186
ADOPTION APPLICATION
If you have problems with this form, just e-mail me the answers, or
here is a printable version.
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** THE LOGAN COUNTY HUMANE SOCIETY RESERVES THE RIGHT TO
       REFUSE OR REJECT ANY APPLICATION FOR ANY REASON.**
Todays Date::
Name::
Address::
State & zip code::
Home phone::
Cell phone::
How you ever adopted from The Humane Society before? If yes, when?:

How many dogs do you have?:

How many cats do you have?:

Are they current on vaccinations?:

Are they spayed or neutered?:

Vet's name and phone number::
Another reference that has known you at least 2 yrs. (Non family and not sonebody living in household.):

Number and age of any children in the home under 14 yrs. old:

Who will be responsible for tis dog/cat?:

Own?: Rent?:
Landlord's name and phone #:

Does your rental contract allow the type of pet you wish to adopt?:

Does your landlord know you are about to adopt this pet and the type of pet it is?:

Do you understand that if for any reason now or in the future you can't keep this pet you will bring it back to us?:

Will this pet be : inside, outside or inside/outside?:

When outside will it be penned, on a trolley system, chained, in a fenced yard or loose?:

How many hours will this pet be left alone and will it be inside or out at that time?:

How will this pet get excersise?:

Why should you not just give this pet away?:

We do our best to assure a pet leaves here healthy, if it should become sick will you provide the vet care needed ?:

If you are interested in a particular pet, what is the name of the animal?: