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2. 
4. ATTENTION: BY FILLING OUT THIS APPLICATION, YOU ARE NOT GUARANTEED A SPECIFIC ANIMAL.
6. The animals adopted from the Davidson County Animal Shelter may have been exposed to various diseases from proximity to other animals. In addition, the physical condition of some animals may be less than ideal due to conditions the animal may have endured before arriving at the shelter; consequently, there is some risk in adoption. The DCAS strives to carefully screen animals and to inform prospective adopters of any perceivable problems, however, some problems may not be evident to the DCAS at the time of adoption. Please understand that after adopting an animal from DCAS it is your responsibility to have it checked by your regular veterinarian within 5 days. The Davidson County Animal Shelter is legally not allowed to treat any sickness or disease after adoption, since we are not a licensed animal hospital.
10. Date*
    Date
11. What are you interested in?*

    1. Cat
    2. Dog
    3. Other
12. Is there a specific animal you are interested in?

    Name of Animal

14. THIS APPLICATION DOES NOT GUARANTEE A SPECIFIC ANIMAL. THIS IS A GENERAL APPLICATION.

    Adoptions are on a first come, first served basis with an approved application. 

18. Contact Information:
20. Full Name*

    First and Last Name

22. Address*
24. City*
25. State*
26. Zip Code*
28. Phone Number*
29. Home or Work Number
31. Email Address*
33. Full name of emergency contact for animal*
    (Other than yourself)
34. Phone*
38. Your Home:
40. Do you...?*

    1. Own
    2. Rent
    3. Rent to Own
    4. Live With Parents
    5. Live In Military Housing
42. Housing style (check all that apply)*

    1. House
    2. Apartment
    3. Mobile Home
    4. Condo/Townhouse
    5. College Dorm
44. Name of landlord / parent / apartment*
45. Phone # of landlord / parent / apartment*
47. My in-home family consists of:
49. Adults*
50. Children*
51. Age of children
53. My new pet will be kept:*

    1. Inside
    2. Outside
    3. Both
55. If both, please explain:
57. My yard is*

    1. Fenced in
    2. Not fenced in
59. If there is no fence, how do you plan to keep your new pet contained?*

    1. Invisible fence
    2. Dog lot
    3. Chain
    4. Zipline/Cable
    5. Leash
    6. Other
61. If other, please explain:*
63. Tell us a little about your family, your lifestyle, and what you are looking for in a new pet.
65. Have you owned pets in the past? *

    1. Yes
    2. No
69. Current Pets:
71. Do you currently own any pets?*

    1. Yes
    2. No
73. Name of animal*
74. Breed*
75. Sex*

    1. Male
    2. Female
    3. Spayed Female
    4. Neutered Male
76. Where is the animal kept?*

    1. Inside
    2. Outside
    3. Both
78. Do you have another pet?*
    -- Select One --YesNo
80. Name of animal*
81. Breed*
82. Sex*

    1. Male
    2. Female
    3. Spayed Female
    4. Neutered Male
83. Where is the animal kept?*

    1. Inside
    2. Outside
    3. Both
85. Do you have another pet?*
    -- Select One --YesNo
87. Name of animal*
88. Breed*
89. Sex*

    1. Male
    2. Female
    3. Spayed Female
    4. Neutered Male
90. Where is the animal kept?*

    1. Inside
    2. Outside
    3. Both
92. Do you have another pet?*
    -- Select One --YesNo
94. Name of animal*
95. Breed*
96. Sex*

    1. Male
    2. Female
    3. Spayed Female
    4. Neutered Male
97. Where is the animal kept?*

    1. Inside
    2. Outside
    3. Both
99. Do you have another pet?*
    -- Select One --YesNo
101. Name of animal*
102. Breed*
103. Sex*

     1. Male
     2. Female
     3. Spayed Female
     4. Neutered Male
104. Where is the animal kept?*

     1. Inside
     2. Outside
     3. Both
106. Do you have another pet?*
     -- Select One --YesNo
108. Name of animal*
109. Breed*
110. Sex*

     1. Male
     2. Female
     3. Spayed Female
     4. Neutered Male
111. Where is the animal kept?*

     1. Inside
     2. Outside
     3. Both
113. Do you have another pet?*
     -- Select One --YesNo
115. Name of animal*
116. Breed*
117. Sex*

     1. Male
     2. Female
     3. Spayed Female
     4. Neutered Male
118. Where is the animal kept?*

     1. Inside
     2. Outside
     3. Both
120. Do you have another pet?*
     -- Select One --YesNo
122. Name of animal*
123. Breed*
124. Sex*

     1. Male
     2. Female
     3. Spayed Female
     4. Neutered Male
125. Where is the animal kept?*

     1. Inside
     2. Outside
     3. Both
127. Do you have another pet?*
     -- Select One --YesNo
129. If yes, please list any other pets. Provide Name, Breed, Sex, Spayed or Neutered, and Where the animal is kept.*
131. Name and number of your current veterinarian.*
133. Veterinary record owner:*
     Please specify whose name your current pet's veterinary records are under if not under your name.
135. Do you have the financial resources to care and provide for this animal?*

     1. Yes
     2. No
137. Have you ever been convicted of animal cruelty or any crime involving animals?*

     1. Yes
     2. No
141. Adoption guidelines:
143. 1. A valid photo ID is required for all adoptions. Must be 18 or older.
145. 2. Written or oral landlord approval is required for all adopters residing in a rental property.
147. 3. All animals adopted will be given age appropriate vaccines and a microchip before leaving the shelter.
149. 4. Any adoption may be approved or refused by a staff member.
151. 5. No adoptions will be made to people known to hoard/collect animals, to individuals who are threatening, who appear to be under the influence of drugs or alcohol, who have been convicted of animal cruelty, or who appear to have impaired judgment.
153. 6. All pets over the age of 4 months in the adoptee’s home must be current on rabies vaccinations as required by North Carolina State Law.
155. 7. Animals will not be adopted to homes where they will be placed on chains or zip lines.
157. 8. Any individual who has previously surrendered a pet to an animal shelter may not be eligible to adopt an animal.
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158. 1. Receive an email copy of this form.
159. Email address

     This field is not part of the form submission.

160. Submit

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