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Story County Animal Shelter Dog Adoption Request Form

  1. Are you at least 18 years old?
  2. Do you own or rent the property in which you reside?
  3. If you rent or live with someone, do we have permission to contact them?
  4. Is the pet a gift?
  5. Please list below any current animals in your household:
  6. PET #1
  7. Male/Femal
  8. Cat/Dog
  9. Spayed/Neutered
  10. Up to date on shots?
  11. PET #2
  12. Male/Femal
  13. Cat/Dog
  14. Spayed/Neutered
  15. Up to date on shots?
  16. PET #3
  17. Male/Femal
  18. Cat/Dog
  19. Spayed/Neutered
  20. Up to date on shots?
  21. PET #4
  22. Male/Femal
  23. Cat/Dog
  24. Spayed/Neutered
  25. Up to date on shots?
  26. PET #5
  27. Male/Femal
  28. Cat/Dog
  29. Spayed/Neutered
  30. Up to date on shots?
  31. Have you ever surrendered a pet to a shelter before?
  32. Have you ever given away or sold a pet before?
  33. Have you ever lost a pet due to being strayed, stolen, hit by car, disease, or old age?
  34. Do you have a fenced in yard?
  35. Will this dog be an indoor or outdoor pet?
  36. Would you be willing to adopt a special needs dog?
  37. Please check any of the reasons that may cause you to return a dog to our animal shelter:
  38. Have you adopted an animal from us before?
  39. Do you still have the animal that you adopted from us?
  40. Do you understand it takes a new dog time to adjust to their new environment?
  41. Do you understand the responsibilities of owning a dog?
  42. Please initial below statement, confirming you have read through completely.
  43. PLEASE ALLOW AT LEAST 2-3 BUSINESS DAYS FOR YOUR APPLICATION TO BE REVIEWED. THERE MAY BE SEVERAL APPLICATIONS FOR EACH ANIMAL. WE DO NOT ADOPT OUT ANIMALS ON A FIRST COME, FIRST SERVE BASIS. SUBMITTING AN APPLICATION IS THE FIRST STEP OF THE ADOPTION PROCESS, AND DOES NOT GUARANTEE APPROVAL FOR AN ANIMAL.
  44. *PLEASE SIGN BELOW, I HAVE ANSWERED EVERYTHING COMPLETELY AND TRUTHFULLY AND I HAVE READ AND UNDERSTAND ALL OF THE ABOVE INFORMATION*
  45. Story County Animal Shelter/Animal Control, is dedicated to finding caring and responsible homes for their animals. All applicable ordinances and laws for Story County are observed and enforced by this department. Story County Animal Shelter appreciates your understanding and support!
  46. THIS APPLICATION WILL REMAIN ON FILE FOR 90 DAYS.- AFTER THAT A NEW ONE MUST BE COMPLETED IF YOU ARE CONSIDERING ADOPTION AGAIN.
  47. Leave This Blank:

  48. This field is not part of the form submission.