humane association

HAL Adoption Application

(Minimum age 18)

1) Our Mission

Humane Association of the Lowcountry (HAL) was formed to enhance the Beaufort County Animal Shelter's foster care program and improve their adoption rates.

Thank you for completing this application form and your interest in our furry children.

2) Applicant(s)

Name (first) (last)

Street Address

Street Address 2

City State Zip

Home Phone Work Phone

Email Address

Age Date of Birth

Drivers License Number

Have you had a tetanus or booster shot in the last five (5) years? Yes No

Please list any allergies or physical, medical (including pregnancy), psychological limitations or disabilities that might hinder you or any member of your family from giving an animal a "forever home."

Have you been convicted of a felony or misdemeanor associated with animal abuse
or neglect within the last seven (7) years? Yes No
Explain:

Co-Applicant

Name (first) (last)

Street Address

Street Address 2

City State Zip

Home Phone Work Phone

Email Address

3) Home Information

Which best describes your home

If Other, please describe

Is your home rented? Yes No

If rented, please list your landlord, contact information (phone / address) and cost of pet deposit.

If you OWN, is ownership listed in your name? Yes No

If No, who's name is it listed under?

How long have you lived at this address year(s).

If less than two (2) years, list your previous address:

Street Address

Street Address 2

City State Zip

4) Please list the names and ages of all children in the home or who visit regularly:

5) Please list all other members of your household (names and ages) whether relatives or not:

6) Are you interested in a specific Cat or Dog?

If so, please indicate the name

or in general what you are searching for: Male Female Either | Adult Baby Either

a particular breed?

7) Animals in the Household

List all pets owned in the last 3 years

Total number of pets owned in the last 3 years

Pet Number One

This pet is a Breed Gender Male Female

Name Age year(s)

How long has (or did) this pet live with you? years.

Where is the pet now

Is this pet

spayed or neutered? Yes No

up-to-date on all shots? Yes No

on monthly heartworm preventive? Yes No

Pet Number Two

This pet is a Breed Gender Male Female

Name Age year(s)

How long has (or did) this pet live with you? years.

Where is the pet now

Is this pet

spayed or neutered? Yes No

up-to-date on all shots? Yes No

on monthly heartworm preventive? Yes No

Pet Number Three

This pet is a Breed Gender Male Female

Name Age year(s)

How long has (or did) this pet live with you? years.

Where is the pet now

Is this pet

spayed or neutered? Yes No

up-to-date on all shots? Yes No

on monthly heartworm preventive? Yes No

Pet Four and Up

If more than 3 please list the same information for the others:

8) References

Name (Vet preferred)

Street Address

City State Zip

Phone

Email Address

Comments - e.g., names of your pets seen by this vet.

* Please notify your Vet / reference that we will be contacting them.

9) Why do you wish to bring a new pet into the home?

10) Is everyone in your household in agreement about adopting a new pet?

Yes No

If No, please explain

11) Is anyone home during the day?

Yes No Sometimes

If No or Sometimes, please explain

12) Is anyone home during the night?

Yes No Sometimes

If No or Sometimes, please explain

13) What provisions will you make for your pet when no one is home or on vacation?

14) What type of training do you plan to provide?

If Other, please explain

15) If you are adopting a cat or kitten.

Do you have a safe place for the cat / kitten to go where he/she can be alone?
(no children, dogs, other cats, ferrets, etc.)?

Yes No

Please describe the area or explain why not

16) If you are adopting a dog, will this dog be a guard dog?

Yes No

If Yes, please explain

17) Is your intent for this pet to be inside or outside?

Inside only Outside only Inside at night, outside during the day Other

If Other, please explain

18) Are you planning to give a pet as a present?

Yes No

If yes, who are you giving a pet to? (relationship)

Note: We do not encourage adoption without the full consent and participation of the future owner.

19) Under what circumstances would you give up your pet?

20) Do you have anything you want to add to this application?

By selecting 'I Agree' below I certify that the information I have supplied above is true and that any false statements may result in nullifying this application. I further understand that this application is the property of Humane Association of the Lowcountry (HAL) and will be retained by them. I also agree to contact a representative of HAL immediately to return any animal that I may have adopted from them should I need to relinquish ownership of this animal at any time.

Selecting 'I Agree' below constitutes an electronic signature that is valid and a legal substitution for my written signature.

Thank you for considering adopting an animal from HAL. Our furry friends are most appreciative.

21) Adoption Requirements - All animals

The following requirements are mandatory for all adoptions.

These requirements are incorporated in and become a part of your Adoption Application.

In order to adopt a HAL animal , you must:

  • BE 18 YEARS OF AGE OR OLDER.
  • Have identification showing your present address.
  • Have the knowledge and consent to adopt from all adults living in your household.
  • Have the knowledge and consent of your landlord or the person owning the premises in which the animal will live.
  • Understand that this application is the property of HAL and will be retained in its files.
  • Understand that HAL has full authority to approve or deny your application.
  • Understand that HAL reserves the right to verify all information submitted on this application, including veterinary information.
  • Understand it is my responsibility to provide a safe, warm, indoor housing for animal(s).
  • Understand that animals allowed to go outdoors need monthly flea and tick treatments.
  • Understand that I must provide quality food and access to water at all times.
  • Understand that I must slowly introduce a new pet to my existing pet(s).
  • Understand that I must spend time playing / training the new animal(s).
  • Understand that I am responsible for bringing the animal(s) to the Vet for vaccinations, physicals, and medical treatment.
  • Understand that I must closely monitor the condition of the animal(s) and contact my Vet immediately when problems are observed.
  • UNDERSTAND THAT I MAY NOT TRANSFER OWNERSHIP OF ANY ANIMAL ADOPTED FROM HAL TO ANOTHER PARTY. IF I MUST RELINQUISH OWNERSHIP OF ANY ANIMAL THAT I NEED TO CONTACT A REPRESENTATIVE OF HAL TO RETURN THE ANIMAL or DISCUSS ALTERNATIVES.
  • Understand that in handling animals there exists a risk of injury, infection, disease including physical harm caused by animals to me, my family or my pets. On behalf of myself, my heirs, personal representatives and executors, I hereby release, discharge, indemnify, and hold harmless HAL, its agents, servants and board from any and all claims, causes of actions, or demands and any nature of cause, including costs and attorney fees incurred or sustained by me in any way connected with my services to HAL but not limited to: animal bites, accidents, injuries, property damage and veterinary fees.

Date:

I Agree I Do Not Agree

your application