Bookmark and Share
Member Login
Username:

Password:


Register
Support Us
Dog Adoption Application
Contact Information

*

*

*

*

*

*
 - 

*

*


x




*=required

Dog Interested In



*


*=required

Personal Information

*

*



*

*

*

*

*


*

*

*

*


*

*

*

*


*




*

*=required

Pet Information / History / Preferences

*


Please list all pets currently in your home. Please provide all details so we can ensure a great match.

*


*

*

*

*

*

*


*

*


*

*


*

*









*=required

Agreement

I understand that in order to be considered as an adopter I must:

  • Be at least 21 years of age.
  • Have a valid driver's license or other government issued ID.
  • Have proof of the knowledge and consent of your landlord if renting.
  • Be willing and able to provide proper care, training, and medical treatment.

I certify that all of the information provided in this application (in its entirety) is true and correct as of the date of submission, and I understand that my application may be denied if false information is given.

I agree that if the pet(s) being adopted does not work out for whatever reason, I will return the pet to TCHS. I understand that the submission of this form does not guarantee I will be approved to adopt a pet from TCHS.

I understand this application will be reviewed and evaluated based on what TCHS feels will be the best match for the pet(s) and for myself.

*

*=required

4111 Old Highway 99W •  Orland, CA 95963  •  (530) 517-1754 •