Wufoo

P.E.I. Humane Society Pet Adoption Application

"Speaking For Those Who Cannot Speak For Themselves"

Please read the following before completing this application

1. Adoption fee includes: spay/neuter surgery, introductory adoption insurance (cats and dogs), microchip ID and registration, parasite treatment if needed and vaccinations (current at time of adoption).
2. Adoptions are subject to an overnight waiting period.
3. We refuse adoptions if we think they are not in the best interest of the animal.
4. All members of your household should consent to this adoption.
5. To adopt you have to be (18) years of age or older.
6. We require valid picture identification with current address and telephone number and two references.
7. Landlord approval is required if you are renting.
8. Fields marked with a ' * ' are mandatory.
I have read and understand the above terms: *

Please type in your initials.
Personal information

Please fill in all the required information
Animal's name: *
I have already spent time with this animal at the P.E.I. Humane Society: *
Yes No
Your Name: * First Last
Your civic address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home phone: - (###) - ### ####
Work phone: - (###) - ### ####
Cell phone (if You Have one): - (###) - ### ####
How long have you lived at this address?

Please enter the years and months you have been at this address.
Email address:
Drivers license or other picture ID number: *
Your accommodations:
Own my own home Live with my parents Rent
Your status:
Attend school Work at home Work outside home Retired
Landlord's name:

This is required if you rent your accommodations.
Landlord's phone: - (###) - ### ####
This is required if you rent your accommodations.
Number of dogs currently at home:
Number of cats currently at home:
Number of other pets currently at home:
Are their vaccinations up to date?
Yes No
Are they spay/neutered?
Yes No
Did Any Of Your Animals Die Of An Infectious Disease In The Last 3 Months?
Yes No
If you own one or more dog and are applying to adopt a dog, have these animals been introduced to each other at the P.E.I. Humane Society yet? *
Yes No
Name of your veterinarian or clinic:
Household/lifestyle information
Number of adults in your household:
Number of children in your household:
Children's ages:
Does Anyone In Your Family Have Allergies?
Yes No
Which adult member of your household will take ultimate responsibility for feeding, training and caring for your new pet?
What will you do with your pet if and when you move?
What will you do with your pet if and when you go on vacation?
Where will your pet stay during the day?

For instance if you work outside the home.
How many hours will your pet be alone?

For instance if you work outside the home.
How do you plan to train your pet and correct behaviour problems? *
Expenses

Providing proper care for your pet costs money. There are annual, occasional and one-time expenses associated with having a pet including: pet food, litter supplies, leash and collar, licenses and/or ID tags, toys, routine veterinary care and possibly emergency care or boarding fees. Cats can live for up to 20 years and dogs for up to 15 years. Are you ready and willing to pay these expenses over the lifetime of your new pet?
I am aware of the expenses in owning a pet: *

Please enter your initials in the box.
Animal Care

Dogs - we recommend that you walk your dog on a leash several times a day, and that you do not let your dog roam at-large. We recommend that you take your dog to a safe off-leash are such as our PEIHS Dog Park. Please do not tie your dog for extended periods of time.
Cats - we recommend that your cat be kept indoors and that it not be allowed to roam at-large outside.
Please provide two references?
Reference #1 name: *
Reference # 1 telephone number: * - (###) - ### ####
Reference # 2 name: *
Reference # 2 telephone number: * - (###) - ### ####
I certify that the information I have provided is true and correct to the best of my knowledge.
Singature of applicant:

Please type in your complete name. You will be required to sign this application if it is approved.
Today's date: / MM / DD YYYY
Do Not Fill This Out

Wufoo

P.E.I. Humane Society Pet Adoption Application

Please read the following before completing this application

Personal information

Household/lifestyle information

Expenses

Animal Care

Please provide two references?

I certify that the information I have provided is true and correct to the best of my knowledge.