Animal Interested In: * By submitting this inquiry, I am expressing my interest in adopting this pet. I understand that in-person adoptions are given priority over online submissions, and that this pet may no longer be available. How many pets are you interested in adopting? Do you have kids in your home? (Please check all that apply.)* Kid(s) under 6 years old 6-12 years old 13+ years old No kids in the house How many dogs do you have in your home?*How many cats do you have in your home?*What type of other animal do you have and how many?* If you have animals already in your home, have they been spayed/neutered?* Yes No No animals in my house Are you willing to adopt a pet that may need more time adjusting in a home (e.g., a fearful/under-socialized pet)?* Yes No Are you willing to adopt a pet that may have some medical needs?* Yes No Notes for your counselor:Name* First Last Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
