Adoption Application - Lancaster | Pennsylvania Society for the Prevention of Cruelty to Animals

Lancaster Center Adoption Application

First and Last Name

Address Type: House, Apartment, Townhome, Other

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Phone Number

Have you adopted from us before?

Yes

Does your home have any species, size, or breed restrictions?

Yes

How many people live in your household?

Ages of children under 18:

Names of all adults living in the home:

Are there any children who visit regularly? (Partial custody, grandchildren, etc.)

Yes

Please list all current pets including their names, species, age, breed, and if they are spayed/neutered:

Please list any pets that you've owned in the past 10 years but do not live with you currently including their name, species, age, breed and where they are currently:

Name of current veterinarian:

Are you financially willing and able to provide annual vaccinations, exams, and routine medical care for your pet? This is an annual commitment of $200 to $400:

Yes

Have you ever surrendered a pet to a shelter?

Yes

If yes, why?

Why are you looking to add a new pet to your home?

What qualities are you looking for in an ideal pet?

My pet needs to get along with (check all that apply):

Young children

Teens

Adults

Elderly

Dogs

Cats

None of the above

On average, how long will your pet be alone per day?

What is your plan for your pet when they're home alone?

Do you have experience with any of the following dog behaviors (check all that apply):

Jumping/Pulling

Fear of Strangers

Food Aggression

Dog to Dog Reactivity

None of the above

Do you have experience with any of the following cat behaviors (check all that apply):

Shy/Hiding

Destructive/scratching

Hyperactive

None of the above

What animal are you most interested in?

By typing my name into this form, I acknowledge that all information on this form is true and correct. I understand that any misrepresentation of the facts may result in the PSPCA refusing adoption privileges to me.

Today's date:

Upload photo of Valid government ID with current address; If it does not show current address, please include photo of mail with address & name

One file only.
100 MB limit.
Allowed types: gif, jpg, png, svg.

If doing you already have a dog, upload record of their recent vaccinations

One file only.
100 MB limit.
Allowed types: gif, jpg, png, svg.