Name
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First Name
Last Name
Home Phone
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Cell Phone
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Email
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Street Address
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City
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State
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Zip Code
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Are you 21 and over?
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Employment
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Work Phone
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Are you a veteran or active duty service member that is currently approved with Pets for Patriots? If so, please email your acceptance letter or email from Pets for Patriots to info@apcsm.org
Veterans and active duty service members who have been approved through Pets for Patriots will receive a 20% discount on adoption fees for eligible animals. To see eligibility requirements for veterans and active service members, please visit https://www.petsforpatriots.org/
Would you like to receive email updates?
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How did you hear about the APCSM?
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Housing
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Own
Rent
Live with parents
Type of Housing
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How long have you lived at this residence?
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Landlord's Phone Number
Please list the ages of all members in the household, including the primary adopter
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Who will be the primary caretaker of your dog?
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Does anyone in your household have allergies to animals?
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Yes
No
If yes, which types?
Please list animals you have owned in the past 5 years.
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Please include name, type of animal, breed, age, sex (spayed/neutered), still own (if no, please explain).
Your Veterinarian
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Veterinarian's Phone Number
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Please call your vet and give them the "ok" to release medical history to shelters. Are your vet records already released?
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If your vet has permanently closed, please email any medical paperwork you do have to info@apcsm.org
If the specific dog you are interested in has already been adopted, are you interested in us contacting you regarding any other dogs?
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Sometimes, we receive multiple applications for one animal. By selecting "No," a staff member will NOT contact you regarding our other available animals.
Please tell us why you would like to adopt a dog.
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Where do you plan to keep your dog when you are at home?
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Where do you plan to keep your dog when you are NOT home?
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How many hours each day will your new puppy/dog be alone?
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How do you plan on socializing your new puppy/dog?
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How do you plan on handling your dog's exercise needs?
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What training methods do you plan on using?
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Do you have any trainers in mind? If so, please list them.
Do you use any of the following methods/equipment for training and/or leash walking?
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Please click all that apply.
If your dog became ill or injured, are you financially prepared to provide medical care?
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The cost of an emergency vet visit can vary greatly based on the injury, condition, what type of pet insurance you have (if any) and whether your pet has a chronic condition that may require multiple emergency vet visits over a pet's lifetime. And if your dog or cat needs surgery, that can end up adding thousands of dollars to your vet bill — anywhere from $1,600 for a simple injury to upwards of $10,000 for something more complex. - CareCredit, 2022
Your adoption counselor will provide detailed information about caring for your new puppy/dog. Do you have any specific questions or concerns?
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Please read: after your submit an application, you must wait to hear from an adoption counselor before coming to the shelter. The APCSM operates by appointment, so a member of our team will contact you to set up an appointment. Please kindly take note that we do not retain applications for extended periods nor for special requests. If you are searching for a specific breed/age etc that is not currently available, it is your responsibility to regularly check our website for available animals. Please check the box below to certify that you have read and understand this statement.
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By typing your name below, I certify that the information I have given is true and that I recognize that any misrepresentation of facts may result in my losing the privilege of adopting a pet. I understand that the Animal Protection Center of Southeastern Massachusetts has the right to deny my request to adopt an animal, and I authorize investigation of all statements on this application.
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