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Jefferson County Humane Society Topeka PetSmart Adoption Application

JCHS PetSmart Adoption Application

Are you 18 or older?
Yes
No
# Of people in your household?
# Of Adults?
# Of Kids?
Do you own or rent?
Own
Rent
Does anyone in your household have allergies to cats?
Yes
No
Don't Know
Are you planning on moving in the next year?
Yes
No
Who will be responsible for this pet?
Who will supervise your children when interacting with your new pet?
In your absence, who will care for your pet?
Where will your cat(s) be kept during the day and night?
Indoors Only
Outdoors Only
Indoors and Outdoors
Are you planning on Declawing?
Yes
No
Why do you want to adopt this pet? Please click all that apply!
How many hours will this pet be home alone?
0-2 hrs.
3-5 hrs.
6-8 hrs.
9-12 hrs.
More than 12 hrs.
How will you confine your new pet to your property?
What behaviors will you not tolerate? Click/Check all that apply.
What do you estimate the yearly expense of owning this pet to be?
$200-$400
$500-$800
$900-$1200
More than $1200
Less than $200
Are there any free-roaming cats or dogs in your neighborhood or nearby?
Have you ever owned your own animals?
Yes
No
Are your current pets spayed or neutered?
Are your current pets vaccinated up to date on vaccinations?
I knowledge and accept having a Veterinarian Background Check.
Yes
No
Have you ever applied to adopted from Jefferson County Humane Society?
Yes
No
Have you ever brought one of your pets to Jefferson County Humane Society?
Yes
No
Please understand it may take your new pet several weeks to adjust to your home... Are you prepared to allow this much time to adjust?
Yes
No
Yes, I understand that if, for any reason, the pet won't work out for my family, I will return the animal to Jefferson County Humane Society.
Yes
No
We receive food for our dogs and cats through Hills at a very reduced cost. Hills would like to be able to send our adopters information and coupons. It is our understanding they will do this through emails however we will be providing your name, address,
Yes Please
No Thank you

*AGREEMENT NOT TO DECLAW CATS:


By adopting a cat from Jefferson County Humane Society, I acknowledge and agree to never declaw the cat or allow anyone else to do so. Any violation of this agreement will result in immediate transfer of ownership back to Jefferson County Humane Society.
Yes, I agree to the terms
No, I don't agree to the terms
I further agree to pay JCHS $500 in liquidated damages, all veterinary expenses related to declawing complications, and any attorney fees and court costs incurred to enforce this agreement.
Yes, I agree
No, I do not agree
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15295 K4 Highway, Valley Falls, Kansas 66088

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