Adoption Form | Farm Animals | Whatcom Humane Society

Name *

First

Last

Street Address *

City, State, Zip Code *

Primary Phone Number *

Alternate Phone Number *

Email *

(e-mail addresses are used for registering microchips of adopted pets and for internal lost & found purposes, your e-mail address is not sold for commercial use)

Please list the people living in your household (include ages of children): *

Tell us about the current ANIMAL members of the new pet’s household:

There are one or more dog(s)
There are one or more cat(s)
There are one or more small animal(s)
There are one or more livestock animal(s)
No animals in the household

Will the animal(s) be kept at the address listed above? *

Yes
No, they will be boarded somewhere else

If no, please provide information on where the animal(s) will be boarded?

Boarding Facility Owner Name:

Facility/Owner Phone Number:

Facility/Owner Street Address:

Facility/Owner City, State, Zip Code

I am interested in: *

Describe your level of experience owning this type of animal? *

Why are you interested in adopting? (companion for other animal, pet for child, etc.): *

Please list the number and type of other animals you currently own: *

Do you currently have a veterinarian? *

Yes
No

If yes, please provide their information: *

Are your animal(s) current on vaccinations (shots)? *

Yes
No
I do not have any animals currently

Do you have a farrier? *

Yes
No
Not Applicable

Please describe where the animal will be kept (including indoor/outdoor facilities, shelter, and fencing): *

Please provide references (not required for chickens, ducks or fowl): (Reference 1) Name: *

Years Known *

Relationship to potential adopter: *

Occupation: *

Phone # *

(Reference 2) Name: *

Years known: *

Relationship to potential adopter: *

Occupation: *

Phone number: *

Veterinary records release *

I hereby release all veterinary records of any/all animal(s) I have had or currently have to Whatcom Humane Society.

Name of veterinary hospital: *

For you to adopt this animal, we need you to: *

Be financially able to provide for the animal’s needs. This includes food, supplies, grooming, farrier, and veterinary care.
Be at least 18 years of age and have verifiable identification.
Understand that this is an adoption, not a sale. The Whatcom Humane Society reserves the right to postpone or refuse an adoption.

Please certify that you agree to the adoption terms by marking the checkboxes below: *

As part of the commitment to having each adoption be a success, I understand that the Whatcom Humane Society may contact me for adoption follow-ups if I adopt a pet.
I certify that all the information in this application is true and I understand that false information may void the application.
I agree that this animal will not be used as food source or for breeding purposes.

I certify that I will follow all the adoption conditions listed above.

Please sign and date this form in person when you adopt an animal from Whatcom Humane Society.

ADOPT a Horse or Farm Animal

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