Online Adoption Application

Invalid Submission Values

Chautauqua County Humane Society Online Adoption Application

**IF THE CAT YOU ARE LOOKING AT SAYS "ADOPT ME AT PETSMART" YOU DO NOT HAVE TO FILL OUT AN ONLINE APPLICATION. APPLICATIONS ARE HANDLED IN THE STORE. THANK YOU**

Today's Date (required)

Example: ##/##/####

Name (required)

Drivers License Number (required)

Address (required)

Address (2)

Township (if applicable)

City (required)

State(required)

Zip (required)

Area Code and Phone Number (required)

Email (required)

Example: janedoe@fakeemail.com

Please Provide An Emergency Contact Name and Phone Number (required)

I own/rent (required)

Own

Rent

Landlord Name & Phone Number

Please attach a copy of your current lease agreement that shows you are able to have pets

How Many Adults Live In Household (required)

How Many Children In Household And Ages (required)

Do You Have Animals At Home Right Now? Please List All Animals Below (Size, Age, Type (ex. Dog, Cat, Fish, Chicken, Hamster) and Personality of Animal (required)

Is There A Specific Animal You Are Interested In (required)

Why Are You Interested In Adopting (required)

What Are You Looking For In An Animal? Give Details On Personality Type, Energy Level,Size, Mannerisms, etc. (required)

What Personality Trait Would You NOT Want To Work With (required)

Where did you see this pet listed (required)

CCHS RESERVES THE RIGHT TO DENY ANY ADOPTION

PLEASE CLICK THE SUBMIT BUTTON ONLY ONCE AND THEN WAIT FOR THE FORM TO PROCESS. THANK YOU.

Invalid code.

Type the code from the image