Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Status

single

married

widowed

divorced

Household information *

Please check all that apply to your household.

House

Apartment

Rent (be able to show proof of landlord's permission to have pets)

Own

Live with parents

Statements of understanding *

I give permission for my adoption photo to be used a social media and marketing materials for ARK.

I understand that if I adopt a pet and cannot keep it, it must be returned to ARK and not given away or sold.

I understand that ARK has the right to reclaim any adopted animal that we feel is being mistreated.

I will have the pet I adopt spayed or neutered by 6 months (if not already fixed), by a Hart County vet as part of the adoption fee, or by another vet at my expense. ARK can reclaim the pet if it is not spayed/neutered ina timely manner.

Date *

MM

DD

YYYY