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Pet Request Form

If you are interested in adopting a specific type of dog or cat please fill in this form and click the "submit" button. We will keep your pet request on file and contact you when we believe we might have a match.

We do deal with all species of animals; including horses, pigs, reptiles, birds, etc. If you are looking for something other than a dog or cat, please skip this and send an email to the address at the bottom of this page (by clicking on the address) with your information and what you are seeking. (Please include your location.)

****NOTE: We can not help you if you do not give us your contact information which includes an e-mail address AND phone number with your area code. This information is only used to contact you should we feel we might have a pet for you. We do NOT sell your information.

In the spaces provided below, back space to delete the wording and type your answers. In the other areas, use the drop down menus and "yes/no" as provided. You are under no obligation by filling out this form. Thank you for letting us help you in your search for a pet.

Species (Example:Dog-Cat) & Breed (Example: Beagle- Persian)Desired:
Purebred animal desired Mix breed is fine

Age Desired:

Sex Desired:
Male Female Doesn't Matter
(NOTE: All animals are spayed or neutered prior to adoption with the exception of reptiles, rodents and birds.)

Fur Length Desired:

Fur Color Desired:

Size Desired:

Training Desired:
Doesn't matter Housetrained Crate-trained
Basic Obedience (sit, stay, down, heel, and NO)
Leash trained (does not pull)

What other pets do you have?
state number and kind of animals

If you have pets are they all spayed or neutered?
Yes No

If you have dogs are they on heartworm prevention?
Yes No

Do you have children? Yes No

Children's Ages:
state children's ages

Do you have a completely fenced in yard? Yes No

Where will the pet live?
Inside Outside Both

Are you willing to have a rescuer visit your home?
Yes No Will consider it

Do we have your permission to contact other shelters/rescues about the pet you are seeking to adopt?
Yes No

Adoption cost you would be willing to pay for pet:

Special Notes: (like why you would make a good home)
I would give this pet a wonderful home because,

Contact Information: (Required to enable us to contact you.)

First and Last Name:
City:
State:
Zip Code:
Home Phone:

E-mail Address:
Please double-check your E-mail Address:
(Please remember the @ and whatever comes after that.)

We can not help you without the above information.

Email: sjhumanesociety@yahoo.com