Sample Shelter Forms
- 1. Cat Adoption Application
- 2. Dog Owner's Questionnaire (Relinquishment Profile)
- 3. Pet/Livestock Adoption Application
- 4. Dog Adoption Application
- 5. Cat Owner's Questionnaire (Relinquishment Profile)
- 6. Adoption Discussion Card - Dog
- 7. Reptile/Amphibian Animal Adoption Application
- 8. Questions to Review by Public Officials and Concerned Citizens
- 9. Adoption Discussion Card - Cat
Group Surrender Form
Greater Birmingham Humane Society, Birmingham, AL
Group Surrender Form
Date_____________________________
(PLEASE PRINT)
Name___________________________________________________________________
Street
Address____________________________________________________________
City_______________________________ State__________ Zip
Code____________
DL #_____________________________ Date of Birth
________________________
Home Phone______________________ Business
Phone_______________________
Number of Dogs___________________ Number of
Cats_____________________
Number of Other__________________ Type of
Other_______________________
SURRENDER
CONDITIONS
I certify that I own the animals located at the above address and
hereby surrender all my interest, if any therein, to the Greater
Birmingham Humane Society.
Signature of Owner_____________________________________________
OFFICE USE ONLY
Police Case
Number(s) ___________________________Total Number of
Animals_______________
Number of Cats Euthanized in Field__________________ Number of
Cats DOA__________________
Number of Dogs Euthanized in Field _________________ Number of
Dogs DOA_________________
Number of Other Euthanized in Field_________________ Number of
Other DOA_________________
Notes_________________________________________________________________________________
_____________________________________________________________________________________
Courtesy
of

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