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Adoption Application

Thank you for your interest in adopting a pet from The Humane Society of Jackson County! It is the goal of The Humane Society of Jackson County ("HSJC") to place pets with responsible individuals and families who will provide a loving and safe environment for their pet. The information you provide helps our volunteers match you and your family with the right pet.

Please remember that the completion of an application form does not guarantee a pet. HSJC reserves the right to refuse adoption to anyone for any reason.
Please complete the following application form and return it to us via mail or fax at the address above. Once your application is reviewed, you will be contacted by an HSJC volunteer.
Applicant Information
Personal Reference:
List persons in household:
If yes, fill out the following fields in as much detail as possible (Type of Pet, Breed, Male or Female? Age of Pet, Is this pet spayed or neutered? Is this pet current on vaccinations? Is this an inside or outside pet?):
If yes, please provide the following information:
Who will care for your pet when you travel or in an emergency?
Pet Preferences
By submiting below, I certify that all of the information that I have given on this Adoption Application Form is true and complete, and I understand that falsification of any of this information may result in the rejection of my application or the removal of an adopted pet from my possession.
Privacy Policy: The Humane Society of Jackson County, Inc. is committed to maintaining your confidence and trust. It is our policy that the personal information you voluntarily provide to us is stored in a secured location, is accessible only by designated volunteers and is used only for the purpose for which you provide the information.