Dog Adoption ApplicationI am interested in adopting a dog from Lake Humane Society*YesNoIs there a specific dog(s) you are interested in? If so, please provide their name(s)Name* First Last Driver's License #*Date of Birth (Month/Day/Year)*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* I live in a:*HouseCondoApartmentMobile HomeOtherAt my current residence listed above, I:*OwnRentLive with Parents/GuardiansIf you do not own your home, please list the homeowner's name and phone:*What is the total number of people in your household?*Are they all present today?*YesNoHow many children (under 18) live in your home?*List their ages:My new dog will live:*Indoors OnlyIndoors/OutdoorsOutdoors OnlyOtherMy new dog will go outside:* By Leash Fenced in Yard Tied Out Outdoor Kennel My home environment is:*Very BusySome ActivityVery Calm and QuietOn average, how many hours will this pet be left home alone each day?*How often do you have guests/gatherings at your house?*What is your experience level?*First Time Pet ParentSome experienceVery experiencedChoose all options that apply. I have experience with:* Small dogs Medium dogs Large dogs Cats or small animals All of the above I want my pet's activity level to be:*HighMediumLowThe main source of exercise for my dog will be:* Walks Runs Hikes Fetch Dog Park Other I want a companion that*I can trainMay require some trainingIs already trainedIf needed, are you willing to seek training for this pet to help him/her adjust to your home?*I want to adopt this pet for:*Myself/Someone else in my householdSomeone in another householdDo you own other pets?*YesNoPlease list the current pets residing in your home. (Click the plus sign to add additional animals)Pet Species and BreedAge/SexLength of ownershipSpayed/NeuteredIndoor/Outdoor What veterinarian do your pets see?Vet Phone NumberAre your pets up-to-date on vaccinations? Date of last visit?What types of animals have your pets been exposed to?Please share a few upcoming days and times that we could call you to discuss your application. **We are available 9am-4:30pm every day*When would you be available to meet the animal at LHS? Choose all that apply: Weekday morning (9-12 pm) Weekday afternoon (12-4:30 pm) Weekend morning (9-12 pm) Weekend afternoon (12-4:30 pm) Are there any additional details you would like to share?Please check each box to demonstrate understanding of LHS adoption polices. If each box is not checked, your application will not be considered.* LHS reserves the right to deny any applicant for any reason LHS strongly recommends that all members of the household interact with the pet before adopting If you are interested in adopting a dog from LHS and you have another dog(s) in your residence, you are required to bring your dog(s) to the shelter for a Meet and Greet If you are misleading or untruthful in the information that you've provided on this application, you will be denied adoption of this animal and may be added to our do not adopt list Adoption fees and deposits are non-refundable under any circumstances I fully understand that completion of this application does not guarantee adoption Type your name in this box to confirm the information provided in this application is truthful and accurate.*Untitled
Pup Crawl!purchase your ticketsPurchase Entries HereLake Humane Society’s 6th annual Pup Crawl bar crawl in Downtown Willoughby is upon us! This event takes place on June 3rd. Secure your tickets now!