DOG ADOPTION APPLICATION

Thank you for your interest in adopting a dog from the Cumberland Valley Animal Shelter (CVAS).  The following information is requested so we can assist in the selection of your new pet. We ask you these questions and considerations so you can really THINK about what it means to bring an animal into your home and the lifelong commitment we are asking of you.

The application process typically requires between 2 - 3 business days, depending on the need to confirm certain information you provide.  For example, renters need the approval of their landlords who do not always reply in a timely fashion.  A copy of your existing lease accompanied by your landlord’s e-mail address can sometimes accelerate this process.

When the shelter is inundated with large rescue situations, the process may take longer.  If veterinary records about your current pets indicate that vaccinations are overdue, your application will only be further considered once those shots are up to date.  Your veterinary clinic may also advise a waiting period of 48 hours to 2 weeks before introducing another pet into your home to assure recent inoculations have taken effect.  This is for the safety of your current pet as well as the safety of the CVAS pet eager to integrate into your home.

Out of state adoptions may take more time and incur additional fees to cover legal policies for animals crossing state lines. If you have a dog and are applying to adopt another dog, an introduction (doggie meet) will be scheduled after your application is in process.  All members of your household must meet and greet your new pet to assure the smoothest transition.

CVAS tries to get pets into their new adoptive homes as quickly as possible.  For that reason, applicants with vaccinations up to date on current pets and more responsive landlords that do not hinder or delay adoptions may supersede an original applicant.  You will be notified if such problems have occurred. 

The Cumberland Valley Animal Shelter reserves the right to refuse adoption to anyone, with or without cause.  In some cases, it may mean that an application is approved but not for that animal.  No animal will be adopted to prospective owners who mislead or fail to provide accurate information for this adoption process.  

All animals are examined upon arrival and are monitored during their stay with us, but there is still a chance that an animal is harboring a disease without visible symptoms.   Veterinary care for adopted animals is the responsibility of the owner after the 14-day health guarantee from us.  The  24petwatch company’s free 30 day sheltercare pet insurance comes with your adoption.  You will receive information through your email address to continue coverage with that company after the 30-day period at a nominal fee. 

Adoption fees are:  $212 for dogs 8 weeks to 6 years old, $153.70 for senior dogs, for senior citizens (people over 62) – 10% off the adoption fee; $85 for kittens, cats 7 months and older donation from the heart; for senior citizens (people over 62) - 10% off the adoption fee.

Included in adoption fees for dogs and cats: spay or neuter, 24petwatch microchip (permanent identification), first set of vaccinations, de-worming, flea and ear-mite treatments if needed, collar, ID tag.  For cats, includes Feline Leukemia and FIV tests plus a cardboard carrier. State law requires rabies vaccinations for cats and dogs.  Franklin County requires dog licensing.  As a convenience, CVAS is an authorized Franklin County dog licensing agent.  Other annual vaccinations along with a physical are highly recommended.  Some area vets have agreed to waive the first office visit fee so you only pay for the shots.

To be eligible for adoption, you must be at least 21 years of age and, if you rent, have the knowledge and consent of your landlord.  A copy of your lease will speed up the process.  All members of the household must meet the animal you intend to adopt.  If you have other pets, their vaccinations must be up to date.

 

Please complete the following information for all adults living in the household:

Full Name:

Address:

City:

State:

Zip Code:

Township:

Home Phone: (including area code)    

Cell Phone: (including area code)     

Email address:

Please list any other names you have gone by: (i.e. maiden name):

If you have lived at the current address LESS THAN FIVE YEARS, please list your previous addresses here (starting with the most recent).

Previous Address:

City:

State:

Zip Code: 

Time frame you lived there:

Previous Address:

City:

State:

Zip Code: 

Time frame you lived there:

Previous Address:

City:

State:

Zip Code: 

Time frame you lived there:



Employer:

 

Adult #2 who lives in the house:

Full Name:

Cell Phone: (including area code)     

Please list any other names they have gone by: (i.e. maiden name):

Please list Adult #2's previous addresses here (starting with the most recent).

Previous Address:

City:

State:

Zip Code: 

Time frame they lived there:

Previous Address:

City:

State:

Zip Code: 

Time frame they lived there:

Previous Address:

City:

State:

Zip Code: 

Time frame they lived there:

 

Adult #3 who lives in the house:

Full Name:

Cell Phone: (including area code)     

Please list any other names they have gone by: (i.e. maiden name):

Please list Adult #3's previous addresses here (starting with the most recent).

Previous Address:

City:

State:

Zip Code: 

Time frame they lived there:

Previous Address:

City:

State:

Zip Code: 

Time frame they lived there:

Previous Address:

City:

State:

Zip Code: 

Time frame they lived there:

Children in the home:



 

Please select which describes your status:

If you rent please list your landlord's name, phone number and email address:
Name:
Phone number (including area code):    
Landlord's email address:

 


Where will the pet be kept during the day?  

Where will your new pet be kept at night?


List all the current pets living in your home or outside your home:

Name: Dog    Cat   Other:
Age: Sex:  M    NM   F   SF

Name: Dog    Cat   Other:
Age: Sex:  M    NM   F   SF

Name: Dog    Cat   Other:
Age: Sex:  M    NM   F   SF

Name: Dog    Cat   Other:
Age: Sex:  M    NM   F   SF

Name: Dog    Cat   Other:
Age: Sex:  M    NM   F   SF

Name: Dog    Cat   Other:
Age: Sex:  M    NM   F   SF

Name: Dog    Cat   Other:
Age: Sex:  M    NM   F   SF

Name: Dog    Cat   Other:
Age: Sex:  M    NM   F   SF


Please complete the following information about pets in your household during the past 5 years who are no longer with you.

Pet's Name:
Dog    Cat   Other:

Why is the pet no longer with you (if deceased, briefly explain cause)?

Pet's Name:
Dog    Cat   Other:

Why is the pet no longer with you (if deceased, briefly explain cause)?

Pet's Name:
Dog    Cat   Other:

Why is the pet no longer with you (if deceased, briefly explain cause)?

Pet's Name:
Dog    Cat   Other:

Why is the pet no longer with you (if deceased, briefly explain cause)?

Pet's Name:
Dog    Cat   Other:

Why is the pet no longer with you (if deceased, briefly explain cause)?

 

Please list all veterinarians you have used (including your current one) location and phone number:

 

 

Home evaluations may be made prior to a dog adoption.  If you already have a dog and are approved to adopt another, a “doggie meet” will be arranged.  No adoption will be made to persons who mislead or fail to provide accurate information for this adoption application.

We understand how introducing a new pet to your home can cause a period of adjustment.  Please contact our adoption counselor for advice and assistance if problems arise.   If you find you can no longer care for an animal you adopted from us, please call to schedule a time to bring the animal back.  CVAS does not refund adoption fees nor exchange one pet for another.  

I certify that the information on this application is true and correct and further authorize Cumberland Valley Animal Shelter to contact any and all references and vet office listed to verify the information provided. 


I certify that the above statements are true and agree to the conditions of this application:
I confirm and agree.     

**Please note that by clicking the confirm and agree button and then pushing submit, you are providing the electronic equivalent of your signature.

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