Humane Society of Burnett County
Online Adoption Application

In order for HSBC to quickly process your application,
please make sure to answer all application questions fully.
We are not affiliated with a group calling themselves Lost, Found and Fostered.

Which animal are you interested in adopting from HSBC?
Full Name (First, Middle, Last):
Date of Birth:
Email Address:
Street Address:
City:
State:
Zip Code:
Home Phone Number:
Work Phone Number:
Cell Phone Number:
Have you ever been declined a request to adopt an animal by an animal rescue, welfare or control facility? Yes
No
If you answered yes to the previous question, please explain:
Name (First, Middle, Last) and date-of-birth for each household resident over the age of 18. Enter "none" if there is no one besides the person listed above.
Number of children in the home under the age of 18 None
1
2
3
4 or more
Do you often have children under the age of five visit? Yes
No
What is your current housing situation? Own a home
Rent a house
Rent an apartment
Have roommate(s)
If you rent, please provide your landlord's name and telephone number:
What pets do you have presently? (Please list species, breed and age of each) Enter "none" if there are no other animals in the household.
Are your current pets spayed or neutered? Yes
No
I have no current pet
If you answered "no" to the previous question, why not?
Are your current pets up-to-date with vaccinations? Yes
No
I have no current pet
If you answered "no" to the previous question, why not?
What pets have you had in the past, and what has happened to them? Enter "none" if you have not owned a pet before.
If you adopt this animal, how will you house him/her? In an outside run
Outside with a doghouse
Running loose outside
Inside our home
Fenced yard
Where will your new animal spend its day?
Where will your new animal spend its night?
If you are adopting a dog, do you plan to crate him/her? If so, for what reason and for how long?
Owning an animal can be costly. Are you prepared and able to spend approximately $800-$1000 a year on vet bills, food and incidentals? Yes
No
Have you done research on this type of animal (breed, temperament, grooming needs, etc.)? Yes
No
If adopting a dog, do you plan to take him/her to obedience training? Yes
No
Are you aware that changing an animal's environment may cause it to have accidents? Yes
No
Who will be responsible for feeding, supplying water and exercising the animal?
If adopting a dog, how will you exercise the animal and for how long?
How often do you travel? What will you do with your pet when you travel?
Is everyone in the household in agreement with adopting this animal? Yes
No
Are you aware of the adoption fee and what it includes? (If no, please refer to our web site) Yes
No
Please provide us with your veterinarian information, including name, clinic and phone number. (Please notify your vet to release your information to HSBC.)
Do you have any other information you'd like to share with HSBC?

HSBC requires that all animals adopted from us be housed inside the home. All animals must be maintained in a matter that exceeds state statutes. HSBC reserves the right to deny adoptions to anyone without stating the reason. All applications will have background checks done through the courts and veterinarians will be contacted. Home visits may occur. Should any problem arise with the animal, HSBC will be contacted. Any animal adopted from HSBC cannot be resold or rehomed without the consent of HSBC.

Click the Submit Form if you have answered all the questions honestly and to the best of your knowledge...and if you've read the above statement and understand it.
Once you submit the form, please wait for it to be sent,
then click "continue" in the top right corner of the page.
or
Return to Adoption Page