Small Animal Adoption Application Is there a specific animal you are interested in? If so, please provide their name(s)Name* First Last Date of Birth (Month/Day/Year)*Driver's License #*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home PhoneCell Phone*Email* I live in a:*HouseCondoApartmentMobile HomeOtherAt my current residence listed above, I:*OwnRentLive with Parents/GuardiansIf you do not own your home, please list the homeowner's name and phone:*What is the total number of people in your household?*Are they all present today?*YesNoHow many children (under 18) live in your home?*List their ages:My new pet will live:*Indoors OnlyIndoors/OutdoorsOutdoors OnlyOtherMy home environment is:*Very BusySome ActivityVery Calm and QuietWhat is your experience level?*First Time Pet ParentSome experienceVery experiencedHave you done prior research on Exotic/Small animals before applying to adopt?* Yes No Most exotic/small animals require daily veggies ( EX: Guinea Pigs 1 cup and Rabbits 2 cups) are you able to provide these fresh veggies daily?* Yes No Describe the ways you plan to allow your exotic/small animal to exercise?*How do you plan to offer enrichment for your exotic/small animal?*What type of enclosure do you have set up for the exotic/small animal you may adopt?*Do you have another exotic/small animal you are planning to bond with the one you are currently interested in?Do you plan to adopt another friend in the future?* Yes No Not sure What steps will you take to introduce the exotic/small animal to a current or future pet?Are you willling to keep your home safe for the animal? (Cords covered, toxic plants removed, etc?)* Yes No If adopting a reptile, are you prepared to provide proper heating, lighting, and humidity? Yes No Are you prepared to feed your new reptile live bugs and fresh greens? Yes No Please list the current pets residing in your home. (Click the plus sign to add multiple animals)Pet Species and BreedAge/SexLength of ownershipSpayed/NeuteredIndoor/Outdoor What veterinarian do your pets see?Vet Phone NumberAre your pets up-to-date on vaccinations? Date of last visit?When would you be available to meet the animal at LHS? Choose all that apply.* Weekday morning (9-12 pm) Weekday afternoon (12-4:30 pm) Weekend morning (9-12pm) Weekend afternoon (12-4:30 pm) Are there any additional details you would like to share?How did you hear about LHS? Choose all that apply.* Friends or family Social media From attending an event Seeing a billboard Petfinder Other If other, please specify here-Please check each box to demonstrate understanding of LHS adoption polices. If each box is not checked, your application will not be considered.* LHS reserves the right to deny any applicant for any reason LHS strongly recommends that all members of the household interact with the pet before adopting If you are interested in adopting a dog from LHS and you have another dog(s) in your residence, you are required to bring your dog(s) to the shelter for a Meet and Greet If you are misleading or untruthful in the information that you've provided on this application, you will be denied adoption of this animal and may be added to our do not adopt list Adoption fees and deposits are non-refundable under any circumstances I fully understand that completion of this application does not guarantee adoption Type your name in this box to confirm the information provided in this application is truthful and accurate.*Untitled First Choice Second Choice Third Choice CAPTCHA
Closing Early 12/11 Our shelter will be closing at 4:30 pm today. Please visit our animals before then!
