Adoption Application

2. Adoption Application

   Applicants are still required to visit office and complete an adoption contract.

   Applicants are still required to visit office and complete an adoption contract.

4. Animal Identification #:

6. Applicant Name:*

7. Email Address

9. Address:*

11. City*

12. State*

13. Zip Code:*

15. Mailing Address (If different than above)

17. Phone Number:*

18. Alternate Phone Number:

20. Driver's License or ID #:*

21. Date of Birth*

23. Is this home your:*
    -- Select One --Full TimeSeasonalVacation

25. How long have you lived at your current address?*
    -- Select One --Less than 2 yearsBetween 2 to 3 years4 years or more

26. If less than 2 years, please list previous addresses below:

28. Will your pet live with you at your current address?
    -- Select One --YesNo

29. If not, where will the pet live?

31. If you rent your home, a “Letter of Authorization” from the property owner is required to house animals at your home.

33. What are your reasons for adopting?*

35. Do you have any pets currently?*
    -- Select One --YesNo

36. Are these pets' vaccinations current?
    -- Select One --YesNo

37. If no, why not?

39. How many dogs or cats have you owned in the past 5 years? *

40. What happened to these pets?

42. Have you ever been convicted of a crime involving an animal? *
    -- Select One --YesNo

43. Have you ever been denied a pet adoption by any organization?*
    -- Select One --YesNo

44. Have you ever been issued a citation by Animal Services?*
    -- Select One --YesNo

46. If you answered “Yes” to the above questions, please explain:

48. Sumter County Animal Services reserves the right to deny anyone the ability to adopt an animal without explanation. In the event an applicant is applying to adopt a certain animal, Sumter County Animal Services reserves the right to assure the animal is matched with the best home for the owner and animal. I understand the requirements and agree to comply with local Animal Ordinances including sterilization (if needed), rabies vaccinations and licensing requirements.

50. Type your name below:

Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field