WELCOME TO THE COLUSA COUNTY ANIMAL SHELTER
 
The following information is requested so that we may assist you in the selection of a new pet. The animal's welfare is our foremost consideration. This application is designed to help us determine if the adoption is in the animal's best interest, and to assist you in finding an animal most compatible with your lifestyle.

The animals available for adoption came here for various reasons. There is always a chance that an animal is incubating a disease without showing any clinical signs.

The fees are as follows: adoption - $10.00 adoption fee,  $50.00 deposit for spay/neuter on dogs - $40.00 deposit for spay/neuter on cats. Identification tag - $2.00 . The animal must be spayed or neutered within thirty (30)days from the date of adoption. You will be asked to send us a veterinarian's certificate or receipt verifying that the animal was spayed or neutered and your deposit will be returned to you at that time.
 

IN ORDER TO BE CONSIDERED AS AN ADOPTER, YOU MUST:

 

  • Be 18 years of age or older;

  • Have identification showing your present address;

  • Have knowledge and consent of your landlord;

  • Be able and willing to spend the time and money necessary to provide training,                                                            medical treatment, humane care and living conditions for the life of your pet.

NAME __________________________

 DATE ____________________

ADDRESS _______________________________________________________

CITY ________________________ STATE ____________ZIP______________

HOME PHONE (Required) _______________ WORK PHONE ______________________
The Colusa County Animal Shelter reserves the right to refuse adoption to anyone. No animal will be adopted to  persons having a history of neglect, not giving humane or veterinary care, losing, giving away, selling,  or having  animals injured or killed by  moving vehicles or staged fights. No animal will be adopted to prospective owners who mislead or fail to provide accurate information on the adoption application.

 

PLEASE FULL OUT THE FOLLOWING QUESTIONNAIRE:

1.   What kind of pet are you here to adopt?

_________Dog     __________Puppy     __________Cat     __________Kitten

2.   Why do you want a pet? _________________________________________________________

3.   Do you have any preferences as to breed, sex, age, size, length of hair, etc.?__________________

______________________________________________________________________________

4.   Is this your first pet?     ________Yes     ________No

5.   List the pets you have previously owned:

TYPE

 SPAYED/NEUTERED   KEPT WHERE? YEARS OWNED WHAT HAPPENED TO PET?

__Dog __Cat      ___Yes ___No          __In  __Out               _________             ____________________

__Dog __Cat      ___Yes ___No          __In  __Out               _________             ____________________

__Dog __Cat      ___Yes ___No          __In  __Out               _________             ____________________

6.   List the pets that are in your home now:

__Dog __Cat     Spayed/Neutered?   __Yes  __No     Kept Where?  __In  __Out     Age_____________

__Dog __Cat     Spayed/Neutered?   __Yes  __No     Kept Where?  __In  __Out     Age_____________

__Dog __Cat     Spayed/Neutered?   __Yes  __No     Kept Where?  __In  __Out     Age_____________

7.   When was the last time your pets were vaccinated? _____________________________________

8.   Are they current with a Rabies vaccination? _________Yes  _________No

       If YES, what county did they receive their Rabies tag? ___________________________________

9.   Who is your veterinarian? ________________________________________________________

       City _________________________________________ Phone# _________________________

10.  Do you currently live in a  _____house     _____apartment     _____mobile home

11.  Do you live   ________in town       ________on a ranch

12.  Do you    _________own   or     _________rent

13.  If you rent, does your lease allow pets?   ______Yes   ______No

14.  If you rent, what is your landlord's name? _________________________Phone # ____________

15.  How long have you lived at the above address? _________________________________________

16.  How many people live in your household? ____________________________________________
        Do all the adults know that you plan to adopt?   ________Yes     ________No
      If there are children, what are their ages?       ___________/______________/______________

17.  Are the children afraid of dogs or cats? _________Yes  _________No

18. Who will be responsible for the care of this pet? _______________________________________

19.  Where will this pet be kept during the day? _____________________ Night? _______________

20.  How many hours will it spend alone without human companionship? ________________________

21.  Where will it be kept when alone ?   _____In house  _____Kennel  _____Fenced yard

         _____On Chain     _____Garage

_______________________________________________________________________________

DOG ADOPTION ONLY:

22.  Do you want the dog for a:  _______ house pet     _______ guard dog     _____ watch dog

                                                     _______companion    _______ company for other pet

23.   Do you have a fenced yard?  _____ Yes     _____ No   If YES, how high? ____________

24.   Do you realize you will probably have to house train your new puppy or dog?  _____Yes   _____No

25.   Are you familiar with the lease and licensing laws in your community?          _____ Yes  _____No

26.   What will you do if your dog chews shoes or shows other destructive behavior? ________________

______________________________________________________________________

27.   Are you familiar with heartworm disease?   _____Yes    _____No

28.   How will you keep your dog confined to your property? (Check all that apply)

       _____ In house     _____ Kennel     _____ Fenced yard     _____On chain     _____Garage

       _____ Patio           _____ On leash

 

CAT ADOPTION ONLY:
 

29.   Do you want the cat for a:  (check all that apply)

        _____ house pet      _____ mouser      _____companion      _____company for other pet  

30.   Will this cat be allowed outdoors?      _____ Yes     _____ No

31.   What will you do if your cat claws the furniture, doesn't use the litter box, or shows other

destructive  behavior?__________________________________________________________

 __________________________________________________________________________

 __________________________________________________________________________
 

FOR SHELTER USE ONLY - DO NOT WRITE BELOW THIS LINE.  THANK YOU

Adoption Review Record _______________________________________________________

Caution File ________________________________________________________________

Landlord Approval ___________________________________________________________

Residence Check on Driver's License ____________________________________________

                                                    _______________________________________

Veterinary Reference _________________________________________________________

Approval ___________________________________________________________________

Restrictions ________________________________________________________________

Adoption Reviewed By _________________________________________________________

  (Two signatures)        _________________________________________________________