Fort Wayne Animal Care & Control Adoption Profile

Fort Wayne Animal Care & Control Adoption Profile

This adoption application and payment portal is for animals who are available for adoption.
Name *

First Name Middle Initial Last Name
Maiden Name
Former Last Name
Name of the animal you'd like to adopt *
Animal Identification Number
This number can be found on the animal's online profile. It starts with A an is followed by six digits.
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Previous Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How many people are currently living in the home where this animal will live? *
Please include children.

Please list all the people living in your home:

First Name

Middle Initial

Last Name

Relationship to You

Age (If under 18)

Person

Please list all the pets currently living in your home:

Male or Female

Species

Color

Age

Time owned

Spayed/
Neutered

Animal's Name

Breed of Dog

Pet 1

Pet 2

Pet 3

Pet 4

Pet 5

Pet 6

The information I have given here in this application is correct to the best of my knowledge. I understand Fort Wayne Animal Care & Control reserves the right to approve or reject this application. *
Please type your first and last name.
*
Date
We love making great matches and having conversations about what you're looking for in a pet! Please check below if you'd like to stay in touch with us.

Yes, I would like to receive promotional information from Hills Science Diet Yes, I would like to be kept up-to-date about what's going on at Fort Wayne Animal Care & Control
OFFICE USE ONLY

Please leave the following field blank - they are for OFFICE USE ONLY.
Person Number:
Person Info Updated:
My Case:
City Limits:

Yes No
Other Pets:
Animals Linked:
Should be Empty:

OFFICE USE ONLY