Name

Address 1

Address 2

City

State

ZIP

Phone

Email

Have you visited the Humane Society of Tuolumne County within the last 30 days?
—Please choose an option—YesNoNot Sure

Pet Type
—Please choose an option—Barn YardBirdCatDogHorsePigRabbitReptileSmall & Furry

Pet Gender
No PreferenceMaleFemale

Pet Age
—Please choose an option—Baby (0 – 6 months)Young (6 months – 1 year)Adolescent (1 – 3 years)Adult (3 – 6 years)

What temperament?
—Please choose an option—No PreferenceFriendlyLovingOutgoingReserved

If you would like a cat, what breed?
—Please choose an option—No PreferenceAmerican BobtailAmerican ShorthairAmerican WirehairBirmanBurmeseHimilayanJavaneseMain CoonManxMunchkinOriental ShorthairPersianRagdollRussian BlueSiameseSiberianSnowshoeSomaliSphynx

If you would like a cat, what color?

If you would like a dog, what size?
—Please choose an option—No PreferenceExtra SmallSmallMediumLarge Extra Large

If you would like a dog, what breed?
—Please choose an option—No PreferenceAfghan HoundAirdale TerrierAkbash DogAkitaAlaskan MalamuteAmerican BulldogAmerican Eskimo DogAustralian Cattle DogsAustralian ShepherdBasenjiBasset HoundBeagleBearded CollieBelgian SheepdogBernese Mountain DogBichon FriseBlack and Tan CoonhoundBloodhoundBorder CollieBoston TerrierBoxerBulldogBullmastiffChinese Shar-PeiChow ChowCocker SpanielCollie (Rough)Collie (Smooth)DachshundDalmatianDoberman PinscherEnglish Cocker SpanielEnglish FoxhoundEnglish SetterFox Terrier (Smooth)German ShepherdGerman Wirehaired PointerGolden RetrieverGreat DaneGreat PyreneesGreat Swiss Mountain DogGreyhoundIrish TerrierIrish WolfhoundJack Russell TerrierKeeshondLabrador RetrieverLouisiana Catahoula Leopard DogManchester TerrierMastiffMiniature Australian ShepherdMiniature Bull TerrierMiniature PinscherMiniature SchnauzerNewfoundlandPembroke Welsh CorgiPointerPoodle (Standard)Poodle (Toy)Portuguese Water DogPugRat TerrierRedbone CoonhoundRhodesian RidgebackRottweilerSaint BernardShetland SheepdogShih TzuSiberian HuskyTibetan MastiffTibetan SpanielToy Fox TerrierWeimaranerWelsh TerrierWhippetWhite ShepherdYorkshire Terrier

Do you have other pets?
—Please choose an option—YesNo

Do you plan to chain or tether your pet?
YesNoUnsure

Do you have children?
YesNo

Do you own or rent your home?
OwnRent

* If you rent, we will require a copy of the lease or written permission before we can release the animal

How much room does your home have for your new animal?
—Please choose an option—A House With Acreage And Fenced Yard/AreaA House With A Fenced YardA Large Apartment/Condo/Townhome With Deck And/Or Fenced YardA Small Apartment/Condo/Townhome With Deck And/Or Fenced Yard

How many hours per day do you plan on spending with your pet?

How long do you want this request to stay active in our database?
0-3 Months4-6 Months7-12 Months1 Year or More