Apply to Adopt!

Please take a moment to fill out the form.

Full Name

Name of animal you wish to adopt

Phone

Full Address (including City & State)

Date of Birth

Do you have other pets? If so, how many (please indicate dogs or cats)?

Is your yard fenced? If yes, what kind of fence?

Do you have children in your home? If so, how many?

Do you rent or own? If you rent, what is landlord's name and phone number?

Name and phone number of current Veteranarian

Are all of your pets spayed or neutered? If no, why not?

By submitting this application, I agree that: 1. I am authorizing, through submission of this form, the Veterinarian named above to release any information and records concerning past or present care of animals to A Second Chance Animal Shelter. I agree to hold harmless and indemnify said Veterinarian for providing such information. 2. I have not, nor has anyone in my household, ever been charged with any form of animal abuse, neglect or cruelty. 3. This animal will be cared for and treated with love and respect. I agree to be fully responsible for it’s well being including the following: Providing veterinary treatment for continued health, adequate and wholesome food, fresh water, and shelter from the weather. If I can not provide for the animal any longer, I will contact A Second Chance Animal Shelter and make arrangements to return the animal to them, with NO refund of fees. I certify all statements made by me on this agreement are true and correct. I agree that ASCAS has the right to refuse adoption or confiscate the above described animal in the event that any statement made by me is found to be false and/or the check for the adoption is returned for insufficient funds.

Thanks for submitting!

Get Involved

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Make a Donation

From supplies to funds, our shelter is always open and appreciate of any sort of donations!

Volunteer Your Time

Apply to volunteer! There are many volunteer opportunities that help our ASCAS residents lives better!