Second Chance Animal Shelter, Inc.
111 Young Road, P.O. Box 136
East Brookfield, MA 01515
(508) 867-5525 * (508) 867-5019 (FAX) * Email
APPLICATIONS for DOGS, CATS, and SMALL PETS

Interested in giving a shelter pet a second chance?

Our On-line Adoption Application will help make the adoption process as smooth as possible and ensure that all of our pets go to loving homes, so please be as accurate and specific as possible. Incomplete applications will not be considered so please take the time to include phone numbers, addresses, and requested information. Information discovered to be falsified or omitted will result in an automatic denial so please be honest.

Please note that we routinely conduct a vet check on current and previous pets. In order to ensure that this check can be done promptly, please call your vet in advance to let them know that you have submitted an application and that they have your permission to release information to Second Chance. Because many vets will not release this information without prior approval, failure to do so may result in a delay in processing your application.

In addition, most applications are responded to via email from the Adoption Coordinators who have varying emails addresses. Please make sure to check your email filters and junk mail so you do not miss any correspondence from us. Thank you for helping us process your application as quickly as possible!

To adopt a dog, please complete the dog adoption application form.

To adopt a cat, please complete the cat adoption application form.

To adopt a small pet, please complete the small animal application form.

If you have any trouble, please call the shelter at (508) 867-5525.

**If you would prefer to download the application (.pdf format) and fax
it to us later at 508-867-5019, you may do so using these links:

**For dogs: Dog Adoption Application
**For cats: Cat Adoption Application
**For small pets: Small Animal Adoption Application


Second Chance Animal Shelter
Dog Adoption Application
Dog Interested In:
Your Name:
Your Address:
Your City, State and Zip:
Your Home Phone # (with area code):
Your Employer:
Your Work Phone # (with area code):
Your Email Address (REQUIRED):

Description of Living Situation:
Additional description of home:

Do you:
If you rent, what is your landlord's name:
Landlord's Phone Number:

Is your yard fenced in:
If fenced or partially fenced, please indicate type and height of fence:


Number of adults in household:
Do all adults in household know you wish to adopt:
Age(s) of children in household:

Do you have other pets:
If yes, please provide name, breed, age and gender of all animals in the household:


Who is your veterinarian (name, address, and phone number):


Are pets current on vaccinations:
Comments:


Are pets spayed/neutered:
Comments:


Are pets on heartworm preventative and if so, what type:

Where are they kept during the day:


Where at they kept at night:


How many hours a day/night is pet left alone:


If you don't have pets now, have you had pets in the past:
If yes, please list pet(s) breed, name, age, gender:


How long has it been since you had the pet(s)?

If this pet's veterinarian was different from the one above, please provide name, address, and phone number:


How long did you have your last pet:

What happened to your last pet (please be as specific as possible):


Is this your first pet:
If this is your first pet,
what vet do you plan to use (name, address, and phone number):

Where will you keep this new pet during the day:

Where will you keep this new pet at night:


How many hours a day will this new pet be left alone:

References are required for your application to be considered and you must include contact information. Please provide three references, at least two being non-family members, (name, address, phone, and email):
1.

2.

3.

Additional Comments:


How did you find this pet?

I have reviewed my application and certify that the information provided on it is true and correct.

Full Name:
Date of submission:


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Second Chance Animal Shelter
Cat Adoption Application
Cat Interested In:
Your Name:
Your Address:
Your City, State and Zip:
Your Home Phone # (with area code):
Your Employer:
Your Work Phone # (with area code):
Your Email Address (REQUIRED):

Description of Living Situation:

Do you:
If you rent, what is your landlord's name:
Landlord's Phone Number:
Number of adults in household:
Do all adults in household know you wish to adopt:
Age(s) of children in household:

Do you have other pets:
If yes, please provide name, breed, age and gender of all pets in the household:


Who is your veterinarian (name, address, and phone number):


Are pets current on vaccinations:

If you have other cats, have they been combo tested for Feline Leukemia (FELV) and Feline Aids (FIV):

Are pets spayed/neutered:

Where are they kept during the day:
Where at they kept at night:

How many hours a day/night is pet left alone:

Do you want your new cat to be:

If you don't have pets now, have you had pets in the past:
If yes, please list pet(s) breed, name, age, gender:

If this pet's veterinarian was different from the one above, please provide name, address, and phone number:

Is this your first pet:
If this is your first pet,
what vet do you plan to use (name, address, and phone number):
Where will you keep this new pet during the day:
Where will you keep this new pet at night:
How many hours a day will this new pet be left alone:

References are required for your application to be considered and you must include contact information. Please provide three (3) references (name, address, phone and email):
1.

2.

3.


How did you find this pet?

I have reviewed my application and certify that the information provided on it is true and correct.

Full Name:
Date of submission:


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Second Chance Animal Shelter
Small Animal Adoption Application
Animal Interested In:
Your Name:
Your Address:
Your City, State and Zip:
Your Home Phone # (with area code):
Your Employer:
Your Work Phone # (with area code):
Your Email Address (REQUIRED):

Description of Living Situation:

Do you:
If you rent, does your lease allow pets:

What is your landlord's name:
Landlord's Phone Number:

Are all adults in the household aware that you wish to adopt a pet/rabbit:
Do they all approve of the adoption?:
Please list the number and ages of the children in the household:

Do you have any other pets:
If yes, what types (please list breed, gender, and ages of your pets):


Who is your veterinarian (name, address, and phone number):


Are pets current on vaccinations:

Are all dogs/cats spayed/neutered:

Where are your pets kept during the day:
Where at they kept at night:
How many hours a day are your pets left alone:
Who will be responsible for the care of the pet/rabbit?
Where do you plan to keep the pet/rabbit?

Questions for Rabbit Adoption Only

Do you own other rabbits:

If yes, do you plan on keeping this rabbit with your other rabbits:


Are your other rabbits spayed/neutered?


What kind of interaction do you plan to have with this rabit and the ones you already own?

If you currently do not own a rabbit, have you ever owned a rabbit in the past?


If so, what happened to it?

If you don't have any pets now, have you had pets in the past?


If so, please list your last pet (name, breed, age, gender)?

How long ago did you have your last pet:
What happened to your last pet:


References are required for your application to be considered and you must include contact information. Please provide three references (name, address, phone, and email):
1.

2.

3.

Additional Comments:


How did you find this pet?

I have reviewed my application and certify that the information provided on it is true and correct.

Full Name:
Date of submission:


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