Laurens County SC Humane Society for the Prevention of Cruelty to Animals

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Application To Adopt A Pet

Please be aware that we do not approve every adoption application we receive. If we believe for any reason that the animal is not a good match for an applicant, we reserve the right to not approve the adoption.

A pet is a lifetime obligation and should be thought of as a member of the family. Consideration should be given to how it will fit into your family's life.

Personal Information

Name *
Address *
City *
State *
Zip *
Residence
Home Phone *
Work Phone
Email Address
Apartment Complex
Apt. Phone
If renting, are pets allowed? Yes No
Family Size
If Children, List Ages

Which Pet(s) would you like to adopt?

Pet's Name(s) *
Breed(s)

Where will your pet live? Inside Only Mostly Inside Mostly Outside Outside Only

Hours alone a day

Do you have a fenced-in area for pets?

Yes No
Approximate size

Have you previously owned a pet? Yes No

Do you currently have any pets? Yes No

Breed and Sex
How many

Are all pets spayed or neutered? Yes No

Are your pets on any medication for ticks and/or fleas? If so, name of product

Are all pets current on shots?

Rabies
Distemper
FELV

Current or past veterinarian

Name
Address
Phone

Heart worm prevention product

Name

Additional comments