Adoption fee is $40 for cats / $75 for dogs
Date: _____________________ Approved by ____________________________
(for office use only)

I am interested in adopting:

Henry County Humane Society - Geneseo

Application for Pet Adoption

Name: Age: (must be 18 or older)        
Address:
City: St: Zip:
Home Phone: Cell:
e-mail (optional):
The Henry County Humane Society---Geneseo's goal is to arrange adoptions which best suit both the animal and its new family. We reserve the right to refuse to place an animal in an unsafe or unsuitable environment. Please complete the following:
Who resides in your home? Name Age
Spouse/Other Adult:
Child:
Child:
Child:
Dogs (breed):
Cats:
Other Pets:
If you have children, have they been around animals:
What happened to the former pets you had? (i.e. run over by car, heartworm, died of old age, etc)
Do you own your home? Or do you rent?
If you rent, please provide: name of landlord and telephone no.
(We must confirm that your landlord permits pets.)
If you adopt an animal, will the pet be inside or outside?
If outside, do you have shelter (such as a dog house)?
Is your yard fenced in (Fencing is not required for all dogs)?
If you have owned a pet in the past or have one now,
please indicate the name of your vet and their phone number:
Give two personal references:
  Name Phone Number
1)
2)

Hopefully, the pet you adopt will live for many years. Have you thought about whether you are ready to make that kind of long-term emotional and financial commitment? Pets are members of the family, not things that you can abandon or ignore when you tire of them. They cost money and need care and attention on a daily basis. Please consider carefully before you take one home!!

Thank you for your interest. We would love to help you find a pet!!!!

Signature: Date:
 


As soon as your application has been approved, we will contact you to arrange a time for you and your new best friend to get to know each other!!!!!!!!

  
  If you are not contacted within 48 hours, you should call (309) 944-5672 to check on your application.  



OR

Print the form and mail to:

Henry County Humane Society
P.O. Box 145
Geneseo, IL 61254