Adoption Questionnaire “very quiet, playful, sweet, and loving. He likes to cuddle, sleep with his people, and play in water.” She spends most of her day outside, playing with her animal friends and chasing down mice. Donate Now Pet Informationspecific pet?*I have a specific adoptable pet in mind!I Do not have a specific adoptable pet in mind.Do you have a specific adoptable pet in mind?YesNoAdoptable Pet Name*The name of the pet you're interested in adopting. Visible from the adoptable pets page.Adoptable Pet ID Number*The ID number of the pet you'd like to adopt. Visible from their adoptable pets profile.Are you interested in adopting dogs or cats from WHS?* Dogs Cats Have you ever adopted from WHS?*YesNoHow did you hear about us?*Statesman Journal NewspaperStatesman Journal WebsiteFacebookInternet SearchI've adopted beforeI've always known about WHSWHS Thrift StoreCraigslistDigital BillboardA FriendAn Outreach EventOtherOther Way You Heard About Us*Contact InformationName* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth* Date Format: MM slash DD slash YYYY Phone*Email* Please choose the preferred contact method.*Please call mePlease e-mail MeLiving CircumstancesType of Residence*HouseApartmentFarmOtherNumber of People in Household*Please enter a number from 1 to 25.Age Groups of People in Household Under 18* No children under 18 Expecting/baby on the way Infant Toddler Preschool Elementary School Middle School High School How many animal(s) are at your home?01234+Please describe the animal(s) currently are at your home, currently own or have owned in the last 5 years.Your Pet 1Type of Pet 1DogCatHorseBirdReptileRodentFishOtherIs Pet 1 Spayed or Neutered?YesNoNot SureGender of Pet 1MaleFemaleNot SureAge of Pet 1Please enter a number from 0 to 30.Is Pet 1 Indoor or Outdoor?IndoorOutdoorBothIs Pet 1 Current on Vaccinations? Yes No Not Sure Do you still have Pet 1? Yes No Why don't you have Pet 1?Your Pet 2Type of Pet 2DogCatHorseBirdReptileRodentFishOtherIs Pet 2 Spayed or Neutered?YesNoNot SureGender of Pet 2MaleFemaleNot SureAge of Pet 2Please enter a number from 0 to 30.Is Pet 2 Indoor or Outdoor?IndoorOutdoorBothIs Pet 3 Indoor or Outdoor?IndoorOutdoorBothDo you still have Pet 2? Yes No Why don't you have Pet 2?Is Pet 2 Current on Vaccinations? Yes No Not Sure Your Pet 3Type of Pet 3DogCatHorseBirdReptileRodentFishOtherIs Pet 3 Spayed or Neutered?YesNoNot SureGender of Pet 3MaleFemaleNot SureAge of Pet 3Please enter a number from 0 to 30.Is Pet 3 Current on Vaccinations? Yes No Not Sure Do you still have Pet 3? Yes No Why don't you have Pet 3?My Future Dog's NeedsMy dog will be primarily*IndoorsOutdoorsThe type of confinement I will have for my dog is*Hours per day my dog will be outside*Please enter a number from 0 to 24.I want a guard dog*YesNoI want a dog to herd or hunt with*YesNoWhen I'm not home, my dog will be* In a crate In the yard On a cable run In a kennel Crate training In the garage Loose in the house With a friend Professionally boarded Other My dog needs to get along with* Children Dogs Cats Other Animals None of the Above My Future Cat's NeedsMy household is*Calm / QuietAverageActive / NoisyMy cat will be*Select one or both. Indoors Outdoors My cat's litter box will be located*My cat needs to get along with* Children Dogs Cats Other Animals None of the Above We plan to declaw our cat(s)YesNoNot SureTerms & ConditionsI certify the information I have provided is true and understand that any false information will nullify the adoption agreement. Upon possible request, I agree to a pre and/or post adoption home inspection by an employee of Willamette Humane Society. I understand that WHS reserves the right to refuse any adoption at their discretion. I agree to the adoption application terms and conditions.* Yes Other comments or requestsWould you like to join our e-mail list?*Our monthly newsletter, Momentary Paws, has the most up to date information about adoptable pets, upcoming events, and exciting news!YesNoJoin Our Mailing List![Email_Signup_Short] CAPTCHAEmailThis field is for validation purposes and should be left unchanged.