The Humane Society of Somerset County, Maryland
Adoption Application For Cats and Kittens
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Terms of Adoption
1. Animals adopted through the Humane Society may not be sold, given, traded, or otherwise transferred without the written permission of the Humane Society of Somerset County, in advance.
2. You must comply with all laws in your local County code for pet ownership, treatment and care, now and in the future.
3. You must adhere to the Humane Society's Adoption Policy as presented.
The Humane Society requires a non-refundable donation of thirty-five ($35.00) dollars for each cat or kitten adopted through us. The donation helps to offset administrative and medical costs.
Name:_________________________________________________ Date:__________________
Street:________________________________________________
City:______________________________ State:______ Zip:___________
Phone: (home)_____________ (cell)_____________ (work)____________ [ ] Don't call at work.
Why do you want to adopt a cat or kitten?____________________________________________
Have you owned, or do you own any pets? Yes____ No____
If yes, how many pets do you currently own? Cats___ Dogs___ Other____
What are their names?_____________________________________________________________
Are they spayed or neutered? Yes____ No____ If No, why not?___________________________
Who is your veterinarian?________________________ Location:____________ Phone:_________
Are there children at home? Yes____ No____ If yes, what are their ages?____________________
What is your living situation? Own home___ Rent apartment___ Other___
If Other, please explain:_______________________________________________
If you rent, we will need your landlord's permission in writing, or a copy of your lease in regard to owning pets.
Where will your cat or kitten sleep?_______________________________________
Are you looking for a particular breed of cat? Yes____ No____
Are you considering adopting a particular cat or kitten? Yes____ No____
If yes, what is it's name?________________________________________
Where did you see the cat or kitten? Our website____ Petfinder.com____ An adoption event____ Cage at vet's or Ace Hardware____ Newspaper____ Other________________________________
Would you consider adopting an older cat, or a cat with special needs? Yes____ No____
Would you consider adopting a mixed breed cat or kitten? Yes____ No____
Are the members of your household aware that you wish to adopt a pet? Yes____ No____
Can you assume the financial responsibility of owning an animal, including vaccinations, vet care and good quality food? Yes____ No____
Please give an estimate of yearly costs for FOOD_______ MEDICAL_______
Are you planning to move in the near future? Yes____ No____
Are you familiar with the animal regulations in your area including Homeowner Association rules and landlord rules which may apply to pet ownership? Yes____ No____
Adoption Contract
By signing below I certify that the information herein is complete and true. I understand that providing false information will void the adoption. I further understand that failure to comply with the terms of the adoption may result in the Humane Society's retrieval of the animal with no reimbursement of fees.
I understand and accept the Terms Of Adoption as presented above.
I have read and understand the Adoption Policy.
I agree to pay The Humane Society of Somerset County, Maryland a non-refundable donation of thirty-five ($35.00) dollars for each cat or kitten adopted.
I agree to supply my landlord's permission in writing or a copy of my lease, if needed.
Signature(s) of Adopter(s):
Date:__________________
_____________________________________________________
_____________________________________________________
Signature of Society Representative:
_____________________________________________________
Cash:__________________
Check#:__________________