Adoption fees are determined on an individual basis for each animal. Contact us with any questions you may have regarding the adoption fee




Having a pet is a commitment for the life of the animal.  Please be sure this is what you want before you take home a pet.  If you are uncertain, please ask for adoption counseling.  We want both you and your new pet to have a happy, healthy and successful relationship.

The question on this application are necessary to provide for the best interest of the pet and the adoptive family.  Completion of this application does not guarantee adoption of any pet.

Please fill out the following completely and accurately.  References are checked.  If your application is approved, it will become part of your adoption contract with the Fairfield Area Humane Society.  FAHS has the right to decline any application based on the information provided herein.  Applicant must be 21 years of age to adopt.

Material misrepresentation on this application will be grounds to terminate the adoption.  The applicant email permits the FAHS to verify all information contained in this application.  You must supply a valid email address!**
**Your email address will be used only for verification purposes.  We DO NOT give away our clients email addresses for any reason if you have further questions regarding our privacy policy click here to read more about it.





Pet I am Interested in:

     Pet's Name or ID Number    


Applicant Information

Name     Age   
Address  City   
Zip code Home Phone #   Social Security # 
Employer 
Address of Employer 
Length of Time at Current Employment   Work # 
Marital Status   Married   Single Widowed/Divorced
Number of Adults in Home  Number of Children & Ages



Living Arrangements

Length of time at current address   Rent / Own 
Is current address   House   Apartment   Condo In the   Country   City
If renting, Name & Phone # of Landlord: 
If less than 3 years at current address, length of time at previous address and landlord's name and phone#
Are you planning to move? Yes Will the new address accept pets? Yes



Questions Regarding Dog Adoption

Do you have a fenced yard?  Yes Type and Height of Fence: 
If you do not have a fence, are you planning to build one?   Yes
How close is your house/apartment to the road?  
Will the dog be primarily outside?   Yes If yes, where?  
What type of shelter is available?  Explain below:



Questions Regarding Cat Adoption
 please note the ALL CATS MUST be indoor cats only

Will this cat live:   Indoors     Outdoors     In a barn
If an outdoor cat, what type of shelter will it have?  Explain below:
How will the cat be prevented from clawing the furniture or carpeting? 


Miscellaneous Information

Would you object to an inspection of the proposed living arrangements for the adopted pet by an FAHS staff member?   Yes     No
Do you currently own a pet?  Yes If Yes   Dog     Cat     Other
Have you previously owned a pet?   Yes If Yes What Type of Pet  
What will you do if your current pet does not adjust to a new pet?  Explain below:
Under what circumstances would you not keep the pet?
 
Allergies Divorce Move New Baby New Job Illness Pet's Behavior Other: 
Why do you want this particular pet?
 
Companion House Pet Protection Hunting Dog Child's Pet Catch Rodents Other:
Have you ever adopted a pet from the FAHS?  Yes If yes, who and when: 
What happened to this pet?  
Have you ever adopted from another agency?  Yes If yes, who and when: 
What happened to this pet?  
Name and Phone # of your Veterinarian: 
Have you ever been convicted of a felony?  Yes
(please explain below)

I certify the information provided on this application is true and accurate to the best of my knowledge.  I also understand that falsified information or significant omissions will disqualify me from further consideration for adoption of a Fairfield Area Humane Society Animal.
Email address:         Today's Date:


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