Pre-Adoption Questionnaire
By completing the questionnaire below, the information you have provided will be sent to the Borderland Humane Society and you will receive a copy of the information also.
Please review the instructions before downloading
If you have a PDF viewer such as Adobe or something similar, you may find it easier and faster to download the file, save it to your computer, open it with a PDF file viewer, fill out the application, and send it to us via email.
Alternatively you may print the application, fill it out, and do one of the following: 1) Scan the completed application and send it to us via email; to info@borderlandhumanesociety.org or 2) send the completed application to our mailing address at 1990 Valley Pine Circle, Int’l Falls, MN. 56649
If you have a PDF viewer such as Adobe or something similar, you may find it easier and faster to download the file, save it to your computer, open it with a PDF file viewer, fill out the application, and send it to us via email.
Alternatively you may print the application, fill it out, and do one of the following: 1) Scan the completed application and send it to us via email; to info@borderlandhumanesociety.org or 2) send the completed application to our mailing address at 1990 Valley Pine Circle, Int’l Falls, MN. 56649
| 3.3c_pre-adoption_questionnaire_form.1-19.pdf |
1990 Valley Pine Circle
International Falls, MN 56649
218-283-9276
Pre-Adoption Questionnaire
Pet ownership is a wonderful experience and a serious responsibility. To assure that you are aware of the responsibilities, and that your new pet becomes a happy member of your family forever, we have prepared the following questions for you to consider. Please complete this form as honestly as possible so we can help match you with the best animal.
To be considered for adoption, you must:Date: _________________
▪ Be at least 18 years old,
▪ Have knowledge and consent of all adults living in your household,Animal(s) of
▪ Have a valid government-issued photo ID, andInterest: ______________________________
▪ Have landlord’s consent to bring an animal onto their property.
Name: ____________________________________________________Phone: __________________________
Address: ___________________________________________________________________________________
1. Are you looking for a: Dog / Cat, Young / Adult / Senior, Small / Medium / Large, Indoor / Outdoor
2. Do you? own rentDo you live in? town farm country Other _____________
3. Where did you hear about our animals? Radio Web/Facebook Newspaper Schools Other ____
4. How many pets currently live in your household?
a. Cats _______ Spay/Neutered? yes noYoung / Adult / Senior
b. Dogs ______ Spay/Neutered? yes noYoung / Adult / Senior
c. Other ___________________________Explain: _______________________________________
5. How will you keep this pet on your property? Indoors only Kennel Fence Fenced yard Invisible fence On leash Tied out Other ____________________________________________
6. If outdoors, explain the facility and provisions: ___________________________________________________
7. Regarding your household, how many adults live with you? ________, how many children? ______________
8. Are you aware of all the costs involved in caring for and owning a dog/cat? yes no
9. Are you familiar with our city ordinances (i.e. leash, excrement and license laws)? yesno
10. All animals making the transition from a shelter, or foster care, to a new home need time to adjust to a new family. The stress of change can lead to unusual and/or undesirable behaviors. Additionally, young animals may not yet be housebroken or trained for obedience. Are you prepared to handle housebreaking, chewing or other destructive behaviors? yes no
11. Are you prepared to commit yourself to caring for this pet for its entire life (maybe 15+ years)? yes no
12. Where did you learn about us? __ Facebook, __Website, __School, __Radio, __News paper, __Other
Signature: ________________________________________________Date: ______________________
Form 3.3C (rev. 1/19)
International Falls, MN 56649
218-283-9276
Pre-Adoption Questionnaire
Pet ownership is a wonderful experience and a serious responsibility. To assure that you are aware of the responsibilities, and that your new pet becomes a happy member of your family forever, we have prepared the following questions for you to consider. Please complete this form as honestly as possible so we can help match you with the best animal.
To be considered for adoption, you must:Date: _________________
▪ Be at least 18 years old,
▪ Have knowledge and consent of all adults living in your household,Animal(s) of
▪ Have a valid government-issued photo ID, andInterest: ______________________________
▪ Have landlord’s consent to bring an animal onto their property.
Name: ____________________________________________________Phone: __________________________
Address: ___________________________________________________________________________________
1. Are you looking for a: Dog / Cat, Young / Adult / Senior, Small / Medium / Large, Indoor / Outdoor
2. Do you? own rentDo you live in? town farm country Other _____________
3. Where did you hear about our animals? Radio Web/Facebook Newspaper Schools Other ____
4. How many pets currently live in your household?
a. Cats _______ Spay/Neutered? yes noYoung / Adult / Senior
b. Dogs ______ Spay/Neutered? yes noYoung / Adult / Senior
c. Other ___________________________Explain: _______________________________________
5. How will you keep this pet on your property? Indoors only Kennel Fence Fenced yard Invisible fence On leash Tied out Other ____________________________________________
6. If outdoors, explain the facility and provisions: ___________________________________________________
7. Regarding your household, how many adults live with you? ________, how many children? ______________
8. Are you aware of all the costs involved in caring for and owning a dog/cat? yes no
9. Are you familiar with our city ordinances (i.e. leash, excrement and license laws)? yesno
10. All animals making the transition from a shelter, or foster care, to a new home need time to adjust to a new family. The stress of change can lead to unusual and/or undesirable behaviors. Additionally, young animals may not yet be housebroken or trained for obedience. Are you prepared to handle housebreaking, chewing or other destructive behaviors? yes no
11. Are you prepared to commit yourself to caring for this pet for its entire life (maybe 15+ years)? yes no
12. Where did you learn about us? __ Facebook, __Website, __School, __Radio, __News paper, __Other
Signature: ________________________________________________Date: ______________________
Form 3.3C (rev. 1/19)
