Harvest Hills Animal Shelter Adoption Application

    * Indicates required fields.

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo


    YesNo



    YesNo



    YesNo


    OwnRentLive with familyLive with other


    YesNo


    Please tell us about the veterinarian whom you would visit with your pet.


    YesNo

    Please provide information about your current pets and those you have owned in the past two years.
    All pets must be current on rabies vaccinations. We highly recommend distemper vaccines as well.

    Pet 1


    CurrentPast


    MaleFemale
    YesNo
    YesNo

    YesNo

    Pet 2


    CurrentPast


    MaleFemale
    YesNo
    YesNo

    YesNo

    Pet 3


    CurrentPast


    MaleFemale
    YesNo
    YesNo

    YesNo

    Pet 4


    CurrentPast


    MaleFemale
    YesNo
    YesNo

    YesNo

    Pet 5


    CurrentPast


    MaleFemale
    YesNo
    YesNo

    YesNo

    Pet 6


    CurrentPast


    MaleFemale
    YesNo
    YesNo

    YesNo

    Pet 7


    CurrentPast


    MaleFemale
    YesNo
    YesNo


    CatDog

    Dog questions

    First time ownerHave had 1 or 2Experienced

    YesNo

    YesNo


    YesNo

    DogsFree Roaming CatsChickensLivestock (goats, cows, horses, etc)

    YesNo

    What do you plan on doing with your pets during and after your move?

    CompanionChildrenGuardHuntingGift

    Cat questions

    First time ownerHave had 1 or 2Experienced

    YesNo

    YesNo

    YesNo

    What do you plan on doing with your pets during and after your move?

    CompanionChildrenMouserGiftBarn cat


    Please provide two non-family personal references.

    Reference 1


    Reference 2


    Please read and digitally sign below by placing your name in the signature box in the following style: /john smith/

    I, the undersigned, have read and truthfully answered the above questions. I understand that Harvest Hills has the right to refuse or deny any application, especially if it is in the best interest of an animal. I realize that any false information could result in forfeiture of the animal. I understand that adoption fees are non-refundable, and that Harvest Hills cannot guarantee the health of any animal.

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