Adoption Application


Please Read This First


All persons interested in adopting a companion animal must fill out an adoption application.

If we seem protective of the animals in our care, we are!

We have invested love, time, energy, and hard earned money into every animal in our care.

The animals often stay with us for months until a home with a good home is found.

Many of these animals came to us from less than desirable circumstances.

We want to ensure they do not end up in the same situations or worse.

The process is easy if all the information you provide is true and complete.

We hope to welcome you into our Adoptive Family.

Please be aware:

v     References will be called.

v     A home visit is required for all potential adopters of Pit Bull Terriers and similar breeds.

v     All animals will be up to date on vaccines, spayed/neutered, prior to adoption.

v     All animals must remain up to date on vaccines and heartworm preventative for their entire life.

v     All adopters must be over the age of 21, with exceptions for exceptional adopters with family support and experience.

v     Adoption donation and signed adoption contract are required.

o       Contract states that adopters are required to administer heartworm preventative, and keep their new companion animal up to date on vaccines.

o       To preview the contract click here

v     If adopter for any reason cannot keep the animal our organization will always accept the animal back and the dog cannot be transferred, given away or sold.


Training and education can be provided through our organization on behavioral or health issues.

If a serious behavior problem arises outside our capabilities we will assist you in finding the right professional.

Every effort is made to ascertain adoptability before pets are available for adoption.

We strive to match the right pet to the new families lifestyle.


The submission of this form sends your completed application to Seneca County SPCA.


Personal Information












Day Phone:


Evening Phone:


What dog are you interested in?


Please provide contact information for your veterinarian including phone:


Please provide 2 references with phone number:


Household Information


Do you own or rent:


If renting, landlord contact information:


Are you moving in the near future?

If yes, please explain:


Please check with your insurance company

before adopting a pit bull dog or similar breed.

Homeowners/renters insurance company:


Please list all persons who live with you (name,age,relation):


Pet Experience


Do you or any of these people have allergies to dogs?



Please list all other pets that live with you:
(Name, breed, age, spayed/neutered, how long owned, kept where)


Have you owned a dog before?

If yes, was it a large breed?
Not applicable

If a large breed, was it a large bully breed?
Not applicable


If yes, please explain what happened to the dog:


If your last dog died, please state dog's name and date deceased:


Have you ever taken one of your pets to a shelter?

If yes, please explain:


Do you have a fenced area on your property?

If yes, please describe:


If you do not have a fenced area, how will your dog relieve/exercise itself?

How active is your lifestyle aside from work?

How many hours each day is your dog alone?

How many hours each day will you spend time with your dog?

Where will your dog be kept when it is alone?

Where will your new dog sleep?


Do you agree to have your home checked prior to adoption?

If you are unable to keep the dog, we require that the dog be returned to us, is this agreeable?

Depending on expenses incurred in the rescue and veterinary care, we require a donation that may be as much as $200, is this agreeable?

All animals are spayed/neutered prior to placement, is this agreeable?

Can you afford the veterinary care required for the life of the dog?
Please consider this carefully.

Are all of these terms acceptable to you?







Thank you for your time and considering adopting a homeless dog   We will contact you within 48 hours.



Thank you for your interest in one of our companion animals!


Seneca County SPCA Family