Adoption Application


If you are interested in adopting a dog, please complete the adoption application below and submit it.
Once received, we will look over the application and contact you!



Contact Information




Household Information


If you rent, what is the name and phone number of your landlord?






Current and Past Pets



Please list the pets that you currently own or have owned in the last five years, beginning with the most recent.
Type / Breed Age Sex Spayed / Neutered? Indoor / Outdoor? Still have?




Animal You Wish To Adopt

I certify that I am at least 18 years of age and the information I have given is true. I recognize that any misrepresentations of facts may result in my losing the privilege of adopting a pet. I authorize any and all verifications of statements made in the application, and I understand that Pets Haven Humane Association, Inc. has the right to deny my application. I am fully aware that I am adopting a living creature and as such that Pets Haven Humane Association, Inc. 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. I am aware that the life expectancy for a dog is as much as 22 years and believe that I will be able to properly care for this animal for the rest of its life. If I am ever unable to continue to care for this animal, I agree to return it to Pets Haven Humane Association, Inc..