First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone
Work Phone x
Cell Phone*
Which animal are you interested in* Choose an animal: 1Cat Not Listed 1Dog Not Listed Abby Saja Angel - Must Apply in Person Azalea - Must Apply in Person Baby Barn Cat Basil Bitty Bernice Bonnie Bookworm Brambles Carter Chamomile Bitty Cheesecake Chipotle Chiquita Clove Bitty Cobalt Cowboy Dale Dean Domino Delaney Dutchess Eowyn Evermore Fancy Felix Frankie Frodo Galadriel Geena Gus (GFS) Gypsy Hissy Elliott Hunter Jack Skellington Jamie - Must Apply in Person Jayden Jayland Jenny - Must Apply in Person Jessamine Journey - Must Apply in Person Judith Kadara Kam Kat Timpf - Must Apply In Person Kenton Lassie Laurel- Must Apply in Person Lou Lou Lumi Madison Magik Magnum Marcus Marie Marty Melody Merry Momma- Must Apply in Person Monique Mushroom (LFS) Nancy Nenya Roz Sally Saoirse Showgirl Dream - Must Apply in Person Spicy Meatball Stella Sycamore - Must Apply in Person Thumper Whizza
Age: (You must be at least 21.) *
Once you submit your online form, you will be contacted after your application has been reviewed and approved by EMAIL and put in direct contact with the designated application counselor. Scott County Humane Society is located in Georgetown, Kentucky. We welcome local adopters and out of state adopters who are willing to come to Georgetown, Kentucky to pick up the adopted pet! Please be sure to check your email. I understand this policy.
What traits are you looking for in a dog?
If you are applying for 1 Cat or Dog Not Listed, what is the name of the animal you are interested in? If there is not a specific animal and you are looking for recommendations, please explain what you are looking for.
Do you own or rent your home* Choose one: Rent Own
In what type of home do you live* Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
If you rent, have you received the approval of your landlord to have an animal Choose one: Yes No
If you marked that you own your house please answer the following question. According to the PVA are you the owner of your property?
If you rent/do not own your property, please enter your landlord/property owner's name and phone number
Please list the age, gender and relation of others who reside in your household*
Do you anticipate any major changes to your household in the future such as a new baby, moving, marriage etc. If so, please explain.
Who in the household will care for the pet*
Will the animal be kept inside or outside* Choose one: Inside Only Outside Only Inside and Outside
How much time will the animal spend alone during the day*
Where will the animal be kept when you are not home*
For all pets living in your household please list the name, species, age, if spayed, neutered or intact, where kept (indoor/outdoor/both), and most recent vaccination date.
Describe how you will train the pet*
Have you ever given up a pet? If yes, please explain*
Is your yard fenced* Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced
What type of fence* Choose one: Chain Link Invisible N/A Privacy
I certify that the information entered on this applicant is true. Enter your name and date*
