Adoption Application

Please complete the Adoption Application.

Household Information

Please list the first and last name of each adult living in the household 18 years or older, beginning with the intended PRIMARY CARETAKER(s) of the pet being applied for:

Mailing Address

Physical Address (if different from mailing)

Pet History and Information

PET HISTORY: Please list all pets, live or deceased, that were owned by anyone in the household in the past five years, EVEN IF THEY ARE NO LONGER IN THE HOUSEHOLD.

If any of the pets listed above are no longer in the household for any reason, please explain why. If they are deceased, please give the cause and date of passing:


List ANY animals ever adopted from or surrendered to any animal shelter:


Please list all veterinarians used for any current or previous pets owned by anyone in the household


For Dogs:

For Cats:


Please list two personal references that are available for us to speak with

Columbia-Greene Humane Society/SPCA
111 Humane Society Road Hudson, New York 12534