Adoption Application

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Use tab to navigate through the menu items.

Please take a moment to fill out the form.

Name, First and Last

Address Include City, State and Zip

Contact Phone

Email

Pet Interested In

Are you familiar with your local animal control ordinances?

Yes

No

Have you ever adopted from us before?

Yes

No

Type of Pet Looking For:

Companion

Mouser

Guard Dog

Hunting Dog

House Pet

Home information

Landlord's name and phone number

If there are children in the home please list their ages

Are you aware of the time/cost involved in maintaining this pet for it's lifetime (est. 12-15 years)

Yes

No

Please describe your fencing

Percentage of time you plan for your pet to be outside

What veterinary clinic do you currently use?

Please list the pets currently in your home:

I understand I must be over the age of 18 to adopt from the Wilbarger Humane Society or must have parental approval.

I hereby certify that the information on this application is true.

Select a date

Your Signature

Leave us a message...

Thanks for submitting!

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